STEMI (IWMI) and Complete Heart Block

An elderly with h/o of HTN and DM II c/o chest discomfort. 

Figure 1

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.

#406