Acute chest pain with ST-segment elevation in lead V1-V3: when you hear hoofbeats, also look for zebras

Abstract

ST-segment elevation (STE) in the anterior precordial leads is the hallmark of anterior myocardial infarction. In rare cases, this ECG pattern may be due to isolated infarction of the right ventricle since leads V1-V3 directly overlie the right ventricular free wall. Herein, we aimed to provide clues to recognize and understand this diagnostic pitfall through a series of 4 patients presenting with STE in the anterior leads.

Keywords: Anterior ST-elevation; Electrocardiogram; Myocardial infarction; Right ventricle; ST-segment.