Concealed Myocardial Infarction Revealed by High Lateral and Posterior Electrocardiographic Leads

Authors

  • Sofia Metaxa 1st Cardiology Department Evagelismos Hospital Athens, Greece
  • Spyridon Koulouris 1st Cardiology Department Evangelismos Hospital Athens, Greece
  • Dimitrios Stalikas 1st Cardiology Department Evangelismos Hospital Athens, Greece
  • Georgios Velissariou 1st Cardiology Department Evangelismos Hospital Athens, Greece
  • Antonis S. Manolis 1st Cardiology Department Evagelismos Hospital Athens, Greece

DOI:

https://doi.org/10.2015/hc.v6i2.376

Keywords:

high lateral electrocardiographic leads, posterior ECG leads, 15-lead ECG, posterolateral myocardial infarction, coronary angioplasty, coronary stenting

Abstract

We report the case of a 50-year-old man with history of hypertension who presented with chest pain and subtle electrocardiographic (ECG) abnormalities. Only with the aid of additional high lateral and posterior ECG leads (V7-9) was a posterolateral acute myocardial infarction identified and subsequently confirmed with positive cardiac enzyme serology. Coronary angiography showed total occlusion of the left circumflex coronary artery, which was successfully recanalized via coronary angioplasty and stenting. This case highlights the use of high lateral and posterior ECG leads (15-lead ECG) in enhancing the diagnostic yield of a conventional ECG in patients presenting with symptoms suspicious for an acute coronary syndrome by disclosing a posterior myocardial infarction and guiding reperfusion therapy.

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Published

2011-03-29

Issue

Vol. 6 No. 2 (2011)

Section

CASE REPORTS

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