A 58-year-old male patient arrived at the emergency department following out-of-hospital cardiac arrest. He had no known cardiovascular risk factors other than smoking. His relatives reported that he had developed oppressive retrosternal chest pain and sweating 3 hours prior to presentation. The first documented rhythm was ventricular fibrillation, requiring 4 electric shocks to restore sinus rhythm and return of spontaneous circulation. The postresuscitation ECG is shown in Figure 1. What is the most likely diagnosis?
Figure 1.
The 12-lead ECG at the emergency room. The 12-lead ECG at the emergency room, showing ST-segment–elevation in lead V1 and V2.
Please turn the page to read the diagnosis.
The ECG revealed sinus rhythm, narrow QRS complex, ST-segment–elevation in lead V1 and V2, with a slight elevation in leads III and aVF and 1-mm ST-segment–depression in leads I and aVL. Surprisingly, no pathological Q waves were evidenced after more than 3 hours of chest pain.
These …
[1]
P. Lambiase,et al.
Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report.
,
2012,
Journal of electrocardiology.
[2]
E. Antman,et al.
Isolated Right Ventricular Infarction
,
2003
.
[3]
E. W. Hancock,et al.
AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part VI: acute ischemia/infarction: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Card
,
2009,
Journal of the American College of Cardiology.
[4]
E. Antman,et al.
Images in clinical medicine. Isolated right ventricular infarction.
,
2003,
The New England journal of medicine.