Inferior Wall ST Elevation Myocardial Infarction in a Patient with Pacemaker

Figure 1

Vignette: 75 yo with h/o HTN, hyperlidemia, AF, s/p PM

c/o nonpleueritic CP with no cough/fever

Figure 2

Non-paced beats (red boxes) are noted to have ST elevations in II, III and aVF with reciprocal changes in I and aVL. There are also ST depression and T wave inversion in V2 and STE V3 to V6.

Troponin ~5 and echo showed infero-posterior wall hypokinenia.

Cath showed lesion in the posterior descening artery.

Interpretation : Inferior Wall ST Elevation Myocardial Infarction (IWSTEMI) in a Patient with Pacemaker