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Case Reports
. 2025 May 26;17(5):e84818.
doi: 10.7759/cureus.84818. eCollection 2025 May.

Aslanger Pattern: A Sign of an Acute Coronary Occlusion

Istria Barros  1 , Alejandro Narvaez  2 , Alberto Navarro  3   4 , Carolina Cardona  5   6 , Juan Senior  7   8
Affiliations
Case Reports

Aslanger Pattern: A Sign of an Acute Coronary Occlusion

Istria Barros et al. Cureus. .

Abstract

ST-elevation criteria miss a substantial number of acute coronary occlusions, resulting in treatment delays and worse prognosis. The Aslanger pattern has been proposed as a new pattern that, despite not meeting the definition of ST-elevation myocardial infarction, represents an acute coronary occlusion. Therefore, patients with this pattern could benefit from early revascularization. The case of a man with acute chest pain is presented, whose initial electrocardiogram showed an Aslanger pattern. Due to the misdiagnosis at the primary care center and the emergency room, the patient did not receive timely optimal management. This case remarks the importance of recognition of this new pattern and its impact on decision-making in patients with acute coronary syndrome.

Keywords: acute chest discomfort; acute myocardial infarction; aslanger pattern; st elevation; unusual causes of chest.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Initial ECG: Sinus rhythm; HR: 49 bpm; negative p wave in the inferior leads, positive in AVR; ST elevation in III and V1, greater in V1 than V2; Q wave in III; ST depression in I, aVL, V5, and V6; inverted T waves in III and AVF.
Note: In the original ECG, there was a subtle ST deviation in V5 and V6, but after improving the quality by digitizing, it is not observed in the presented image.
Figure 2
Figure 2. (A) Occluded right coronary artery. (B) Circumflex coronary artery with a 70% proximal lesion. (C) and (D) Left anterior descending coronary artery with a severe lesion in the proximal third. (E) and (F) Successful angioplasty and stent placement in the left anterior descending coronary artery.
Figure 3
Figure 3. Follow-up ECG after checking the extremity leads: sinus bradycardia, HR: 52 bpm, and qR in III
See this image and copyright information in PMC

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