Open AccessElectroangiographic Correlation of Simultaneous ST-Segment Elevations of Anterior and Inferior Segment: Who Is the Culprit?
Author(s) -
Pankaj Jariwala,
Shanehyder Zaidi,
Kartik Jadhav
Publication year - 2021
Publication title -
indian journal of clinical cardiology
Language(s) - English
Resource type - Journals
eISSN - 2632-4644
pISSN - 2632-4636
DOI - 10.1177/26324636211015509
Subject(s) - medicine , culprit , cardiology , artery , coronary arteries , stenosis , right coronary artery , myocardial infarction , occlusion , lesion , coronary angiography , surgery
Simultaneous ST-segment elevation (SST-SE) in anterior and inferior leads in the setting of ST-segment elevation myocardial infarction is often confounding for a cardiologist and further more challenging is the angiographic localization of the culprit vessel. SST-SE can be fatal as it jeopardizes simultaneously a larger area of myocardium. This phenomenon could be due to “one lesion, one artery,” “two lesions, one artery,” “two lesions, two arteries,” or combinations in two different coronary arteries. We have discussed an index case where we encountered a phenomenon of SST-SE and coronary angiography demonstrated “two lesions, one artery” (proximal occlusion and distal critical diffuse stenoses of the wrap-around left anterior descending [LAD] artery) and “two lesions, two (different coronary) arteries” (previously mentioned stenoses of the LAD artery and critical stenosis of the posterolateral branch of the right coronary arteries). We have also described in brief the possible causes of this phenomena and their electroangiographic correlation of the culprit vessels.