Acute myocardial infarction with Aslanger pattern AMI with Aslanger pattern
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Abstract
The diagnosis of ST-segment elevation myocardial infarction (STEMI) requires well-defined electrocardiographic criteria, however there are cases without the typical change on the electrocardiogram yet presenting acute coronary occlusion. We report a case of ST-segment elevation myocardial infarction with Aslanger pattern, characterized by the following findings: ST-segment elevation in DIII but not in other inferior leads, ST-segment depression in any of leads V4 to V6 (but not in V2) with a positive or terminally positive T-wave, ST-segment in lead V1 higher than ST-segment in V2. The diagnostic difficulty resulted in a longer delay than recommended until coronary reperfusion therapy. Coronary angiography showed severe obstructive lesions in the circumflex artery and right posterior descending branch, which made the case even more challenging. The patient presented good clinical evolution after primary percutaneous coronary intervention, being discharged from hospital within 48 hours. Atypical myocardial infarction cases with borderline electrocardiographic criteria require knowledge and adequate preparation from medical teams, enabling timely treatment and mortality reduction
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