Acute Inferior Myocardial Infarction with Right Ventricular Involvement resembling Acute

On admission the physical examination was normal with a blood pressure of 130/90 mmHg. The initial electrocardiogram (Figure 1A) showed sinus rhythm with convex-upwards ST segment elevation (transmural injury) decreasing from V1 to V3 and acute inferior myocardial infarction pattern with Q waves and ST segment elevation of transmural injury in leads III and aVF. The patient was medicated with aspirin, clopidogrel (300 mg) and enoxaparin, and sent to the catheterization lab. Angiography revealed total proximal occlusion of the right coronary artery (RCA) (Figure 1B) and discrete irregularities in the LAD and LCx. (Figure 1C).