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The present study aims to compare the amount of ST segment changes recorded by horizontal electrocardiography (hECG) with standard ECG (sECG) in patients with acute anterior and/or lateral ST segment elevation myocardial infarction (STEMI).Consecutive eligible patients (n = 58) who were diagnosed with acute anterior and/or lateral STEMI were included in the study. After recording simultaneous sECG and hECG by placing precordial leads (V3-6) horizontally on the left 4th intercostal space, ST segment changes were compared.The mean ST segment changes (mV) on hECG were significantly higher than sECG in V4 (0.27 ± 0.2 vs. 0.21 ± 0.21, p = 0.001), V5 (0.21 ± 0.17 vs. 0.12 ± 0.16, p 0.001) and V6 (0.09 ± 0.1 vs. 0.04 ± 0.12, p 0.001), respectively. When hECG and sECG were compared in patients with BMI 30 kg/m(2), mean ST segment changes (mV) on hECG were significantly higher than sECG in V4 (0.29 ± 0.21 vs. 0.21 ± 0.24, p = 0.004), V5 (0.22 ± 0.19 vs. 0.13 ± 0.17, p 0.001) and V6 (0.11 ± 0.11 vs. 0.04 ± 0.11, p 0.001), respectively.Mean ST segment changes in patients with anterior and/or lateral STEMI were significantly higher and easily detectable on hECG compared with sECG. We suggest that hECG be used in conjunction with sECG to diagnose anterior and lateral wall STEMI in cases of diagnostic doubt.

We report the case of a patient with acute anterolateral myocardial infarction without ST segment elevations and incipient cardiogenic shock due to complex high grade left main (LM) stenosis and tight calcified ostial left anterior descending (LAD) artery stenosis. Rotablation followed by stent deployment achieved a successful angiographic outcome with no associated clinical complications. During 30 days follow-up, the patient remains stable. An acute interventional approach in unprotected LM coronary stenosis is associated with high procedural risk. Combining that procedure, i.e., rotational atherectomy, with stent placement enhanced procedural success and clinical outcome in this case.

A 39-year-old Kuwaitian man was referred to our catheterization laboratory with an acute anterolateral myocardial infarction. Eighteen months before, he received bioresorbable vascular scaffolds (BVS) in the left anterior descending coronary artery (LAD) and obtuse marginal (OM) branch in Kuwait. After 12 months of treatment with aspirin and clopidogrel, both medications were discontinued …

A 60-year-old man with no prior cardiac history presented to the emergency room with 1.5 hours of substernal chest pain. An ECG revealed ST-segment elevation in leads V2 to V6. Acute anterolateral myocardial infarction was diagnosed, and thrombolytic therapy in the form of tPA was administered, with resolution of the …

We report on a 34-year-old woman who presented with acute anterolateral myocardial infarction 12 weeks postpartum. Cardiac catheterization documented a left main coronary artery dissection with complete occlusion of the left anterior descending artery. The surgical treatment and the complicated postoperative course are discussed here.

Thrombolytic therapy was administered to a 64-year-old man with an acute anterolateral myocardial infarction who had received cardiopulmonary resuscitation (CPR) for 24 minutes. At the time of thrombolytic therapy, the patient was alert and without clinical or radiographic evidence of injury. The patient developed a retroperitoneal hematoma related to femoral line placement, as well as subcutaneous bruising of the anterior chest wall; both were self-limited. No long- term morbidity developed, and the myocardial infarction was aborted. The use of thrombolytic therapy for patients with acute myocardial infarction who have received CPR is reviewed. In the absence of clinical or radiographic evidence of trauma from CPR, patients with acute myocardial infarction should not be excluded from receiving thrombolytic therapy solely because of having had CPR or the duration of CPR.

We report the history of a young man who developed an acute anterolateral myocardial infarction secondary to blunt chest trauma in an automobile accident. Arteriography demonstrated that the patient had sustained a left anterior descending artery tear and a coronary-ventricular fistula from the first septal branch. Different pathogenetic mechanisms with their specific complications and diagnostic features are discussed.

A 67-year-old man with acute anterolateral myocardial infarction had recurrent ventricular fibrillation that required insertion of temporary pacemaker. When a permanent pacemaker was inserted stable pacing was not obtained until the catheter tip stimulated the left atrium. Four months after discharge from the hospital the patient was doing well, and left atrial pacing has continued.