Acute isolated right ventricular myocardial infarction masquerading as acute anterior myocardial infarction.

To cite: Sidhu MS, Aggarwal K, Fay WP. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2012008087 DESCRIPTION Right ventricular (RV) myocardial infarction (MI) often accompanies inferior left ventricular (LV) MI. However, isolated RV MI is very rare. A man (age range 30–40 years) presented with acute chest pain. ECG revealed ST segment elevation in leads V1–V4 (figure 1). He was taken to the cardiac catheterisation laboratory with presumptive diagnosis of acute anterior MI. However, angiography revealed a normal left coronary artery (figure 2A) and normal LV systolic function. The right coronary artery (RCA) was occluded proximally (figure 2B). A percutaneous coronary intervention (PCI) was performed. Post-PCI angiogram revealed a non-dominant RCA (figure 2C). ECG after PCI revealed a significant decrease in the injury current in the right-precordial and midprecordial leads (figure 3). Peak serum troponin was 5.2 ng/mL. This case demonstrates that isolated acute RV MI due to occlusion of a non-dominant RCA can masquerade as acute anterior MI.