Type 1 ST-segment elevation in the right precordial leads associated with acetylcholine-induced localized spasm of the conus branch of the right coronary artery

Heart Rhythm ◽  
2009 ◽  
Vol 6 (11) ◽  
pp. 1681-1682 ◽  
Author(s):  
Kensuke Ihara ◽  
Mitsuhiro Nishizaki ◽  
Harumizu Sakurada ◽  
Masayasu Hiraoka
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
St Segment Elevation ◽  
St Segment ◽  
The Right

scholarly journals Anomalous origin of left main coronary artery from right coronary artery in a patient presenting with inferior wall myocardial infarction: a case report and literature review

2019 ◽  
Vol 3 (4) ◽  
pp. 1-6
Author(s):  
Dipesh Ludhwani ◽  
Vincent Woo
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Left Main Coronary Artery ◽  
Anomalous Origin ◽  
Single Coronary Artery ◽  
Inferior Wall ◽  
Left Main ◽  
St Segment Elevation ◽  
St Segment ◽  
The Right

Abstract Background Anomalous origin of the coronary arteries is seen in less than 1% of the general population. Single coronary artery (SCA) is a congenital anatomic abnormality identified by a single coronary ostium giving rise to one coronary artery. We present an extremely rare variant of the left main coronary artery (LMCA) branching off from the right coronary artery (RCA) and following a prepulmonic course. Case summary A 72-year-old woman presented due to ongoing chest pain with associated ST-segment elevation involving the inferior leads. Emergent cardiac catheterization revealed a 99% ulcerated lesion in distal RCA, which was intervened on with angioplasty and stent placement. The RCA was noted giving rise to LMCA, which followed a prepulmonic course (anterior to pulmonary artery) before trifurcating into a small caliber left anterior descending, ramus intermedius, and hypoplastic left circumflex arteries. The non-malignant course of the aberrant LMCA was confirmed on the coronary computed tomography angiogram. The patient was discharged home on guideline-directed medical therapy. Discussion The patient illustrated congenital SCA with type RIIA pattern of the aberrant vessel based on the Lipton anatomic classification for SCA. The prepulmonic course of SCA is usually benign and can be managed conservatively.

Discriminating Between Right Coronary Artery and Circumflex Artery Occlusion by Using a Noninvasive 18-Lead Electrocardiogram

2007 ◽  
Vol 16 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Shu-Fen Wung
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Right Coronary Artery ◽  
Coronary Occlusion ◽  
Atrioventricular Node ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary ◽  
The Right

• Background Differentiating occlusion of the circumflex branch of the left coronary artery (also called the circumflex artery) from occlusion of the right coronary artery is often difficult because either may be associated with a pattern of acute inferior myocardial infarction on the electrocardiogram. • Objectives To determine if an inexpensive 18-lead electrocardiogram can provide useful information in differentiating sites of coronary occlusion. • Methods Continuous 18-lead electrocardiograms, including standard 12-lead, right ventricular, and posterior leads, were recorded in 38 and 50 subjects undergoing percutaneous coronary interventions in the right coronary artery and the circumflex artery, respectively. • ResultsST-segment elevation in the posterior leads was twice as frequent during occlusion of the circumflex artery as during right coronary occlusion (P < .001). ST-segment elevation in the right ventricular leads and inferior leads occurred more often during occlusion of the right coronary artery than during occlusion of the circumflex artery. ST-segment depression in lead aVL is highly suggestive of right coronary occlusion, whereas ST-segment elevation in posterior leads without depression of the ST segment in lead aVL is highly sensitive and specific for occlusion of the circumflex artery. • Conclusions ST-segment changes in the 18-lead electrocardiogram can be used to differentiate between occlusions of the circumflex artery and occlusions of the right coronary artery. Knowing which vessel is occluded before percutaneous coronary intervention can help in planning the procedure and recognizing when patients are at high risk for disturbances in conduction at the atrioventricular node.

scholarly journals de Winter syndrome or inferior STEMI?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shijun Wang ◽  
Liang Shen
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Right Coronary Artery ◽  
Reperfusion Therapy ◽  
Total Occlusion ◽  
Case Presentation ◽  
St Segment Elevation ◽  
St Segment ◽  
St Elevation ◽  
The Right

Abstract Background The de Winter electrocardiography (ECG) pattern is associated with acute total or subtotal occlusion of the left anterior descending coronary artery (LAD) characterized by upsloping ST-segment depression at the J point in leads V1–V6 without ST-segment elevation. Case presentation We report an atypical style case of the de Winter ECG pattern accompanied by ST elevation in inferior leads. The patient underwent emergency coronary angiography, which revealed total occlusion of the proximal LAD with no observable stenosis in the right coronary artery. Conclusion ECG-related changes in acute total LAD occlusion can present with the de Winter pattern and ST elevation in inferior leads. Recognizing this atypical ECG pattern is critical for immediate reperfusion therapy.

Anomalous interarterial right coronary artery culprit vessel in ST-segment elevation myocardial infarction

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ilias Nikolakopoulos ◽  
Bernardo B. C. Lopes ◽  
Evangelia Vemmou ◽  
Judit Karacsonyi ◽  
João Cavalcante ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

scholarly journals Sudden Cause of Cardiac Death—Be Aware of Me: A Case Report and Short Review on Brugada Syndrome

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Jagadeesh K. Kalavakunta ◽  
Vishwaroop Bantu ◽  
Hemasri Tokala ◽  
Mihas Kodenchery
Keyword(s):  
Brugada Syndrome ◽  
Past History ◽  
Short Review ◽  
Case Presentation ◽  
St Segment Elevation ◽  
First Case ◽  
St Segment ◽  
The Right ◽  
Malignant Arrhythmias

Introduction. Brugada syndrome accounts for about 4% of sudden cardiac deaths (SCD). It is characterized by an ST-segment elevation in the right precordial electrocardiogram (EKG) leads.Case Presentation. We describe a 39-year-old healthy Caucasian man who was admitted to the intensive care unit after being cardioverted from ventricular fibrillation (VF) arrest. His past history was significant for an episode of syncope one month prior to this presentation for which he was admitted to an outlying hospital. EKG during that admission showed ST elevations in V1 and V2 leads, a pattern similar to Type 1 Brugada. A diagnosis of Brugada syndrome was missed and the patient had a cardiac arrest a month later. We discuss a short review of Brugada syndrome and emphasize the need to look for it in patients presenting with SCD and malignant arrhythmias.Conclusion. Physicians should always consider Brugada syndrome in the differential diagnosis of ST-segment elevation in anterior precordial leads of EKG and associated VT/VF. Although more than 17 years have passed since the first case was reported, increased awareness of this syndrome is needed to identify patients with EKG changes and treat them accordingly to prevent incidence of (SCD) and its deleterious complications.

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