Acute inferior myocardial infarction caused by left anterior descending artery occlusion

Abstract

INTRODUCTION: Acute myocardial infarction with ST segment elevation in the inferior leads suggests an acute occlusion of the right coronary artery (RCA). Occlusion of the left anterior descending artery (LAD) usually causes ST segment elevation in the precordial leads and reciprocal ST segment depression in the inferior leads. But ST segment elevation in the inferior leads due to occlusion of the LAD is uncommon. MATERIAL AND METHODS: It’s the clinical case of 60-year-old previously healthy man presented inferior STEMI. Physical examination, urgent coronarography, some laboratory and instrumental tests were performed. RESULTS: A 60-year-old previously healthy man presented to an outpatient clinic with complaints of intensive burning retrosternal chest pain with irradiation to the left hand that had started half an hour before.ECG revealed ST segment elevation in leads II, III, aVR, aVF, V4-V6 and reciprocal ST segment depression in the lead aVL.Coronary angiography was performed: there was left coronary artery dominance, RCA was intact, subocclusion of the proximal LAD was found; “slow flow” phenomenon was noted. A drug-eluting stent was introduced into the proximal LAD. CONCLUSIONS: Inferior acute myocardial infarction can be caused by untypical branch of coronary artery and it’s belongs to rare clinical cases.

Keywords

• myocardial infarction
• stemi
• coronarography
• electrocardiogram