Acute inferior myocardial infarction secondary to proximal obstruction of right coronary artery

Male, 64-year-old patient, who was admitted with symptoms of chest pain typical of acute coronary syndrome.

• ECG (admission) shows a pattern of inferior AMI with RV compromise (confirmed by V4R) + second degree AVB, type I. Associate typical type 1 Brugada pattern in V1 lead. As there was no hemodynamic room available, the patient underwent fibrinolytic therapy with streptokinase (1 hour infusion).

• ECG (post STK) shows a pattern resembling that of a variant of Brugada Syndrome or atypical Brugada pattern: «Lambda like wave» in inferior leads.

• Later, the patient underwent coronary angiography, which showed critical residual lesion of proximal RCA, which in turn was treated with STENT implant.