Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2010 Jan;15(1):90-3.
doi: 10.1111/j.1542-474X.2009.00344.x.

Inferolateral ST elevation as a first sign of left anterior descending artery occlusion

Po-Chao Hsu  1 , Tsung-Hsien Lin, Ho-Ming Su, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu
Affiliations
Case Reports

Inferolateral ST elevation as a first sign of left anterior descending artery occlusion

Po-Chao Hsu et al. Ann Noninvasive Electrocardiol. 2010 Jan.

Abstract

Combined anterior and inferior ST elevation due to occlusion of wrapped left anterior descending artery (LAD) is well reported in the literature. However, there is rare literature mentioned about inferolateral ST elevation in this patient group. Herein, we report a case of acute proximal wrapped LAD occlusion with initial electrocardiographic sign of inferolateral ST elevation. The most likely mechanism of this electrocardiographic finding might be related to old anteroseptal myocardial infarction, combination with other coronary abnormality, such as chronic total occlusion of left circumflex artery that caused larger injury current in inferolateral than anteroseptal myocardium, and made anteroseptal leads reveal isoelectric pattern.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A) Electrocardiogram revealed ST elevation over lead V4‐V6, lead II, III, and aVF. (B) Follow‐up electrocardiogram revealed resolution of inferolateral ST elevation, but all precordial leads had pathologic Q wave and serial ST‐T change.
Figure 2
Figure 2
(A) Coronary angiography revealed left anterior descending artery (LAD) was a relatively long vessel, which extended to the inferoapical wall (small arrows), and distal left circumflex artery (LCX) with total occlusion (large arrow). (B) Proximal LAD subtotal occlusion with thrombus formation (arrow). (C) Right coronary artery gave Rentrop grade 3 collateral to distal total occlusion lesion of LCX (arrow). (D) Successful angioplasty with stenting over LAD and thrombolysis in myocardial infarction (TIMI) 3 flow was restored.
See this image and copyright information in PMC

References

    1. Sadanandan S, Hochman JS, Kolodziej A, et al Clinical and angiographic characteristics of patients with combined anterior and inferior ST‐segment elevation on the initial electrocardiogram during acute myocardial infarction. Am Heart J 2003;146:653–661. - PubMed
    1. Tamura A, Kataoka H, Nagase K, et al Clinical significance of inferior ST elevation during acute anterior myocardial infarction. Br Heart J 1995;74:611–614. - PMC - PubMed
    1. Sapin PM, Musselman DR, Dehmer GJ, et al Implications of inferior ST‐segment elevation accompanying anterior wall acute myocardial infarction for the angiographic morphology of the left anterior descending coronary artery morphology and site of occlusion. Am J Cardiol 1992;69:860–865. - PubMed
    1. Sasaki K, Yotsukura M, Sakata K, et al Relation of ST‐segment changes in inferior leads during anterior wall acute myocardial infarction to length and occlusion site of the left anterior descending coronary artery. Am J Cardiol 2001;87:1340–1345. - PubMed
    1. Duzenli MA, Aygul N, Aydin MU, et al An unusual electrocardiographic presentation of acute obstruction of the left anterior descending coronary artery. J Electrocardiol 2008;41:107–109. - PubMed

Publication types