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J Korean Soc Emerg Med > Volume 23(1); 2012 > Article
Journal of The Korean Society of Emergency Medicine 2012;23(1): 141-144.
A Case of Acute Total Obstruction of the Left Main Coronary Artery Presenting with Atypical Momentary Electrocardiogram Changes
Sung Woo Cho, Byung Ok Kim, Young Sup Byun, Choong Won Goh, Kun Joo Rhee, Hyo Seung Ahn, Sang Hoon Park, Ran Heo, Eui Suk Chung, Jeong Hoon Kim
1Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea.
2Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. jhkimmd@paik.ac.kr
3Department of Chest Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
ABSTRACT
Acute total obstruction of the left main coronary artery (LMCA) is a serious emergency condition requiring prompt diagnosis and treatment. Unless properly treated, it will likely progress to cardiogenic shock and a high mortality rate. We report a case of acute LMCA total obstruction presenting with atypical momentary electrocardiogram (ECG) changes including right bundle branch block with left axis deviation, and ST-segment elevation in aVR and aVL. We focus on the unusual ECG changes associated with LMCA obstruction which should be noted in order to ensure revascularization without delay, especially when this condition is accompanied by cardiogenic shock.
Key words: Electrocardiogram, Acute left main coronary artery obstruction, Right bundle branch block
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