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Patient
56-year-old man, hypertensive, smoker, hospitalized at H + 4 for typical chest pain; entry ECG;
Trace
Sinus rhythm, normal PR interval; elevation in the inferior leads, with higher amplitude of the elevation in lead III versus lead II; deep reciprocal depression in aVL and V2;
Trace
Recording of right and posterior leads; absence of right ventricular or posterior wall extension;
Exergue
Various electrocardiographic parameters have been proposed to differentiate a right coronary thrombosis and a circumflex thrombosis in the setting of an inferior infarction. Due to anatomical differences between patients, each parameter taken individually has limited sensitivity and specificity.
This patient presented an acute coronary syndrome due to thrombosis of the second segment of the right coronary artery. In an inferior infarction, coronary angiography can reveal a lesion of the right coronary artery or of the circumflex artery.