- HPI: 24F with acute chest pain x 1 hr
- Cath: the culprit was a proximal LAD lesion (open, with TIMI-3 flow)! It had embolized to the distal LAD, which was a “type III” or “wraparound” LAD supplying the inferor wall. So this was an antero-infero-lateral MI. The proximal lesion was stented and the distal was treated with antiplatelet and antithrombotic therapy.
- Key ECG: Sinus rhythm. Inferior and lateral ST elevation with reciprocal ST depression in aVL. There is no significant PR segment depression. Some might suspect pericarditis in a young person with diffuse ST elevation.
- Link to full case @ Dr. Smith’s ECG Blog: 2013-05-23