Extra Leads Solve the Case

Singla et al present a case about a 56-year-old white male with a prior history of hypertension and hyperlipidemia who was brought to the emergency department with chest pain lasting 30 minutes. ST depression in leads VI-V4, along with minimal ST elevations in inferolateral leads, suggested the possibility of a coronary event. Cardiology service was consulted, and a 15-lead ECG, which included posterior leads, was performed which revealed 2-mm ST elevations in leads V8-V9. A diagnosis of ST-elevation myocardial infarction with posterior wall involvement was made. The patient underwent emergency cardiac catheterization; revealing 100% occlusion of the mid-left circumflex coronary artery.