A 60-year-old woman with multivessel coronary artery disease status-post percutaneous coronary intervention with a drug-eluting stent to the left anterior descending and circumflex arteries 1-year prior presented to the emergency department with unrelenting chest pain intermittently relieved with sublingual nitroglycerin that started abruptly 3 days prior. She also had a history of ischemic heart failure with reduced ejection treated with furosemide 40 mg, metoprolol succinate 50 mg, and losartan 50 mg. A 12-lead ECG was obtained on presentation (Figure 1).
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This article was published in Annals of Emergency Medicine, 82, Triska J, George J, Rector G, et al., Acute coronary occlusion in a patient with prior known right bundle branch block: another chink in the armor for the ST-elevation myocardial infarction criteria, 219-221, © 2023 by the American College of Emergency Physicians.”
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