Work

Atypical Presentation of Non-dominant Right Coronary Artery Occlusion: Precordial ST-Segment Elevation

Year: 2025

Type: article

Abstract: This case report details a rare presentation of ST-segment elevation myocardial infarction (STEMI) in a 46-year-old male, highlighting an unusual electrocardiographic (ECG) pattern where proximal total occlusion of the right coronary artery (RCA) manifested with ST-segment elevation (STE) in both inferior leads (II, III, aVF) and, strikingly, anterior precordial leads (V1-V6). Typically, precordial STE is a hallmark sign of anterior myocardial infarction (MI), commonly linked to occlusion of the left anterior descending (LAD) coronary artery. This patient's ECG initially suggested a widespread myocardial insult, but subsequent coronary angiography definitively pinpointed a complete blockage in the proximal RCA, while the LAD and circumflex arteries were normal. This case should influence diagnostic reasoning by compelling clinicians to consider a wider differential diagnosis for STEMI and to avoid absolute reliance on classic ECG patterns. The diagnostic workup of such unusual cases should include clinical presentations with updated ECG criteria and integrated imaging algorithms such as comprehensive transthoracic echocardiography to ensure accurate diagnosis and timely reperfusion therapy.

Source: Cureus

DOI: 10.7759/cureus.90336

Authors: Sinan Cerşit, Lütfi Öcal

Institutions: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu High Specialization Training and Research Hospital

Language: English

Topic: Acute Myocardial Infarction Research

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4413299255