Simultaneous ST-segment elevation in the precordial and inferior leads in acute myocardial infarction

In general, ST-segment elevation in either the precordial or inferior leads is the most common electrocardiography (ECG) finding in patients with acute myocardial infarction (AMI). However, simultaneous ST-segment elevation in the precordial and inferior leads is a rare finding. A 48-year-old male patient was admitted with a diagnosis of AMI upon detection of ST-segment elevation in the DI, aVL, and V1-6 leads and reciprocal changes in inferior leads. A subsequent ECG taken before submission to the cardiac catheterization laboratory showed that the ST-segment approached the isoelectric line in the anterior leads, while remaining elevated in the D2, D3, and aVF leads. Coronary angiography revealed 95% stenosis in the left anterior descending (LAD) coronary artery with total occlusion distally, and some insignificant stenoses in the right coronary artery. A bare metal stent was placed in the LAD, with balloon dilatation of the distal lesion. He was discharged on the seventh day of admission.