Two successive electrocardiograms of an old male with acute myocardial infarction: What on earth was going on?

Ann Noninvasive Electrocardiol. 2022 Sep;27(5):e12950. doi: 10.1111/anec.12950. Epub 2022 Apr 7.

Abstract

A 68-year-old male complained of a sudden 2-h chest pain accompanied by dizziness and diaphoresis. His consciousness lost several times because of ventricular fibrillation attack. Emergent CAG showed proximal left anterior descending (LAD) occlusion, but two previous successive electrocardiograms established diagnoses of non-ST-elevation myocardial infarction (NSTEMI) and STEMI respectively, indicating that the patient had experienced acute subtotal occlusion of proximal LAD to total occlusion of the left main coronary trunk (LMT). It is vital to identify de Winter pattern associated with proximal LAD lesion in view of the potential circulatory collapse, fatal arrhythmias and sudden cardiac death from it.

Keywords: cardiac arrest; myocardial infarction; sudden death.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Coronary Angiography
  • Electrocardiography
  • Humans
  • Male
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / diagnosis
  • Non-ST Elevated Myocardial Infarction*
  • ST Elevation Myocardial Infarction* / complications
  • ST Elevation Myocardial Infarction* / diagnosis
  • ST Elevation Myocardial Infarction* / pathology
  • Ventricular Fibrillation