J Transcat Intervent.2019;27:eA20190002.

Anterior myocardial infarction with an unusual electrocardiographic pattern

Aníbal Pereira Abelin, Marco Tulio Zanettini, Carlos Antonio Mascia Gottschall, Alexandre Schaan de Quadros

DOI: 10.31160/JOTCI201927A20190002

ABSTRACT

The finding of ST segment elevation in the electrocardiogram identifies many patients with acute myocardial infarction, but presents low sensibility. Recently, some new electrocardiogram patterns have been described for the early identification of myocardial infarction. We report a case of a 53-year-old male patient who presented with an anterior myocardial infarction and an unusual electrocardiographic pattern. The electrocardiogram presented a slightly widened QRS complex, slow progression of the R wave in the anterior wall, and an ascending ST segment with tall and symmetrical positive T waves. Coronary angiography demonstrated a wraparound left anterior descendent artery with medial occlusion. The original report with the abovementioned electrocardiographic pattern occurred due to occlusions in the proximal segment of the left anterior descendent artery. Our patient is one of the few cases showing occlusion of the medial segment of the left anterior descendent artery described after the original report of this unusual electrocardiographic pattern. This case report illustrates the problem of uncommon electrocardiogram presentations in patients with myocardial infarction.

Anterior myocardial infarction with an unusual electrocardiographic pattern

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