入院時心電図検査で広範前胸部誘導に著明なST上昇がみられた下壁急性心筋梗塞症の1例

Acute Inferior Myocardial Infarction with Associated Anterior ST Elevation:A case report

要旨　患者は84歳，女性．胸部症状があり虚血性心疾患が疑われ，近医から当院に緊急搬送となった．12誘導心電図検査でⅡ，Ⅲ，aV_F，V_1～6の広範囲誘導で著明なST上昇がみられた．緊急冠動脈造影検査で右冠動脈の完全閉塞がみられ，引き続いて同部位への緊急経皮的冠動脈形成術を施行した．緊急経皮的冠動脈形成術施行後に行った12誘導心電図検査ではST上昇は改善していた．右冠動脈の閉塞による下壁梗塞であったが，12誘導心電図検査で非常に広範囲の誘導に著明なST上昇がみられた貴重な症例であった．

　We report a case of an 84-year-old woman who presented at the emergency department with an acute coronary syndrome with significant ST segment elevation in the anterior and inferior leads. The coronary angiogram showed proximal occlusion of the right coronary artery. The right coronary artery was treated successfully with thrombectomy followed by coronary stent implantation. Electrocardiographic findings may be regarded as showing left anterior descending artery occlusion or double vessel occlusion. The present case suggests that the right ventricular myocardial infarction associated with ST-segment elevation and combined with inferior and precordial STE may be produced only by an inferior-RV MI.