Cardiovascular Diseases & Diagnosis

Tombstone ST Segment Elevation in Double Vessel Coronary Artery Disease; Who is the Culprit?

Abstract

Yutthapong Temtanakitpaisan, Renee Dallasen and Craig S. Smith

We describe a 66 year-old male who presented with chest pain and ST segment elevation in the anterior leads. The typical culprit lesion is in the left anterior descending artery (LAD). However, concomitant lesions in the other coronary arteries may make an accurate diagnosis of the actual “culprit lesion” more challenging. Understanding the electrical basis of electrocardiograms can provide important clues in identifying and treating the true lesion.