PMC10250731_01
The upper ECG shows a 2 mm ST elevation (red arrow) at leads DII, DIII, aVF, V1, with reciprocal depression (blue arrow) in DI, aVL, and V6. This ECG suggests an inferior myocardial infarction with ST elevation. The lower ECG with right-side lead indicates a 2 mm ST elevation (red arrow) at lead V3R, and V4R which suggests a right ventricular myocardial infarction. RCA was suspected as culprit lesion.
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F1
ECG showed 2 mm ST elevations in II, III, aVF, V1, V3R, and V4R with reciprocal depressions in I, aVL, and V6 (Figure 1).
Coronary angiography revealed patent coronaries including LCA (left) and RCA (right) without significant flow-limiting lesions.
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F2
The subsequent coronary angiography revealed normal coronary without flow-limiting lesions (Figure 2).
Right coronary artery IVUS showed no significant stenotic lesion, no thrombus, and no dissection in proximal RCA (image 1 to 5), mid RCA (image 6 to 10), and distal RCA (image 11 to 20).
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F3
IVUS of RCA showed no evidence of significant stenotic lesions, thrombus, or dissections (Figure 3).