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Case Reports
. 2014 Jun 1;41(3):335-7.
doi: 10.14503/THIJ-13-3338. eCollection 2014 Jun.

Acute anterior ST-elevation myocardial infarction and electrical storm secondary to nondominant right coronary artery occlusion

Joseph John Franco  1 , Michael Brown  1 , Riyaz Bashir  1 , Brian O'Murchu  1
Affiliations
Case Reports

Acute anterior ST-elevation myocardial infarction and electrical storm secondary to nondominant right coronary artery occlusion

Joseph John Franco et al. Tex Heart Inst J. .

Abstract

A 42-year-old man emergently presented with chest pain and anterior ST elevation. Refractory ventricular arrhythmias and shock developed rapidly. A coronary angiogram revealed the acute occlusion of a nondominant right coronary artery. After percutaneous coronary intervention, the anterior ST elevation and ventricular arrhythmias resolved. The electrocardiographic pattern was a result of isolated right ventricular infarction that in turn caused profound electrical and hemodynamic instability. We discuss the cause and pathophysiology of this patient's case, and we recommend that interventional and general cardiologists be aware that anterior ST elevation can be caused by the occlusion of a nondominant right coronary artery.

Keywords: Arrhythmias, cardiac/etiology; coronary disease/physiopathology; coronary vessel anomalies/diagnosis/therapy; electrocardiography; myocardial infarction/etiology; ventricular dysfunction, right/diagnosis/etiology.

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Figures

Fig. 1.
Fig. 1.
Left coronary angiogram (caudal projection) shows the dominant left circumflex coronary artery and chronic occlusion of an obtuse marginal branch.
Fig. 2.
Fig. 2.
Angiogram shows the occluded right coronary artery.
Fig. 3.
Fig. 3.
Right coronary angiogram shows the artery after revascularization.
See this image and copyright information in PMC

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References

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