Transient ST-segment elevation in precordial leads by acute marginal branch occlusion during stent implantation

• We appreciate the importance of a correct reading of the electrocardiogram.
• We learn to decipher all the possibilities offered by an electrocardiogram, within these differential diagnoses.
• We value the importance of proper care in acute cases such as acute coronary syndrome with ST elevation.

The isolated right ventricular infarction is a rare entity. Our case presented a selective occlusion of an acute marginal branch that supplies the right ventricular free wall with isolated ST elevation in precordial leads simulating an occlusion of the left anterior descending artery and without pseudonormalization in inferior due to the non-involvement of the main branch in the ischemic process. Our case clearly illustrates a rare differential diagnosis when a new ST segment elevation appears in earlier precordial leads in patients with symptoms of myocardial ischemia.