An elderly with h/o of HTN and DM II c/o chest discomfort.
There is inferior wall MI (STE II,III and aVF/reciprocal changes in I and aVL) and complete heart block. ST elevations can also be seen in V3-V6 (extension to the lateral wall). Some studies indicate that STE in lead V6 during inferior wall STEMI was associated with larger infarct size and a greater frequency of major cardiac arrhythmias and higher incidence of pericarditis during a patient's hospital course.
Cardiac catheterization showed an occlusion of the proximal right coronary artery (RCA). Intervention was done. Because of the persistence of the heart block, a permanent pacemaker was eventually implanted.
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