Combined ST elevation in a case of acute MI: How to identify
Combined ST elevation in anterior and inferior ECG leads in acute myocardial infarction is not a rarity. It is both interesting and challenging to indentify the infarct related culprit artery.

International Journal of Applied and Basic Medical Research, the authors report the case of a middle-aged male with acute myocardial infarction whose admission ECG showed ST elevation in lead II, III, aVF as well as from V1-V3. 90% of such cases are due to single vessel occlusion- majority due to proximal RCA occlusion and the remaining due to mid to distal LAD occlusion.

ECG features to differentiate between these two vascular occlusions are discussed. In this case at hand, lead III ST elevation of 2.5 mm and V2/V3≥ 1 indicates proximal RCA as the IRA and the same has been confirmed by pre-discharge coronary angiogram.

Read more about the case here:
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