A 68-year-old diabetic male presented to the hospital complaining of sudden pain lasting three hours.
The ECG showed a qR and E-ST pattern in the lower leads and a reciprocal D-ST in I and aVL.
There was also a negative displacement of point J followed by a descending D-ST in leads V1-V2 and horizontal in V3.
The patient was diagnosed with inferoposterior AMI with lateral extension and received fibrinolytic treatment with tenecteplase.
Two hours after admission ECG showed a qR pattern and a lower E-ST in the lower leads, a reciprocal D-ST in I and aVL, a J wave followed by a negative D1-ST descending and a V6 derivation.
Twelve hours after admission, the ECG showed a qR pattern with minimal E-ST in the lower leads, a high R wave in V2-V3, a narrow S wave in V5-V6, a small convex R-wave associated with a convex.
These ECG data were interpreted as inferential-posterior myocardial infarction associated with incomplete right bundle branch block (RBBB) and SB-type pattern.
One day after admission, ECG showed a rR' (J) pattern along with convex T-ST and flat T wave V1 and a high T-wave with E-ST V2 and ascending line R.
On the third day of admission, the ECG showed a rsR' pattern with positive T-wave in V1 derivation and a large R-wave with STE in V2 mounting.
The maximum values of creatine kinase and troponin I were 2,279 U/l and 14.6 ng/ml, respectively.
The telemetry could not demonstrate the occurrence of arrhythmias.
An echocardiogram showed an inferoposterior akinesia.
The patient refused to undergo a flecainide test and coronary arteriography.
Two years after discharge, ECG showed a pattern of inferior myocardial infarction, a rsR' complex in V1 derivation and an S wave in the manifest left lateral leads, and an R2-S ratio >1 in E2.ST.
