Year: 2025
Type: article
Study design: Case Report
Abstract: Current guidelines categorize acute coronary syndrome (ACS) into unstable angina, ST-segment elevation myocardial infarction (STEMI), and non-ST-segment elevation myocardial infarction (NSTEMI). However, this categorization paradigm can lead to the underrecognition of acute coronary occlusion (ACO), especially when electrocardiographic findings are atypical. The Aslanger pattern is a critical ECG signature characterized by isolated ST-segment elevation in lead III with concomitant ST depression in leads V4-V6. It is often associated with severe multivessel disease, poor prognosis, and high mortality. We present two cases of chest pain with ECGs consistent with the Aslanger pattern. Coronary angiography confirmed three-vessel disease, with ACO in at least one vessel and severe stenosis in another. Notably, Patient 1 suffered in-hospital mortality, while Patient 2 had an uneventful recovery, underscoring the impact of timely intervention. This report emphasizes the value of recognizing the Aslanger pattern to bridge a diagnostic gap in ACS, enabling early identification of ACO, prompt reperfusion therapy, and ultimately, improved patient outcomes.
Authors: Ying Zhu Chen, Zheng Yang Yao, Li Wen Lin, Qiao Yun Luo, Rong Li, Xin Jun Zhao
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Funders: National Natural Science Foundation of China, China Academy of Chinese Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou University, National Science and Technology Major Project, National Key Research and Development Program of China, Basic and Applied Basic Research Foundation of Guangdong Province
Awards: G3317138784, G4079969734, G7960084360
OpenAlex ID: W7110046306