A patient in their 30s with a history of hypertension presented to the emergency department with acute chest pain that had begun 4 hours earlier. On examination, the patient’s blood pressure, heart rate, and respiratory rate were 117/78 mm Hg, 88 beats/min, and 20 breaths/min, respectively. A 12-lead electrocardiogram (ECG) was obtained (Figure) at the time of admission. The high-sensitivity troponin I level was 0.155 ng/mL (normal range: <0.034 ng/mL; to convert to μg/L, multiply by 1.0). The B-type natriuretic peptide and serum electrolyte levels were within normal limits. The patient was diagnosed with acute ST-segment elevation myocardial infarction (STEMI) and was immediately transferred to the catheterization laboratory.
Li Y, Zhu H, Zhai G. Coronary Artery Lesions at the Same Site Presenting With Different Electrocardiogram Patterns. JAMA Intern Med. 2022;182(7):768–769. doi:10.1001/jamainternmed.2022.1302
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