Electrocardiographical case. An elderly lady with chest pain. Diagnosis: isolated posterior myocardial infarct (MI)

Chiam Paul, S.C. Chuah, P. Wong, W.S. Teo. A lady with chest pain.

Singapore Medical Journal 2006; 47: 166-8.

Abstract

A 72-year-old woman with diabetes mellitus, hypertension and dyslipidaemia presented with severe chest pain of four hours duration. Her electrocardiogram (ECG) showed tall R waves in leads V1-2, and ST segment depression in leads V1- 4, consistent with an isolated posterior myocardial infarction (MI). Emergency coronary angiogram showed an occluded left circumflex coronary artery, and primary angioplasty and stenting was performed. The ECG criteria for isolated posterior MI and pitfalls in using the conventional 12-lead ECG are discussed.