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  • Title: A totally occluded right coronary artery presenting with a normal electrocardiogram.
    Author: Nanavati VI, Knapp AL, Passelaqua S.
    Journal: J Invasive Cardiol; 2003 Jun; 15(6):355-8. PubMed ID: 12777678.
    Abstract:
    Total occlusion of the right coronary artery (RCA) typically manifests as ST-segment elevation in the inferior leads and sometimes the lateral precordial leads of the surface electrocardiogram (ECG). We report a case of a patient with a normal electrocardiogram on presentation who, on angiography, revealed a totally occluded proximal RCA. Emergency angioplasty and stenting was successfully able to recanalize the entire RCA and restore TIMI III flow. ECGs performed post-procedure showed minimal change. The existence of a subendocardial microvascular network may have allowed this patient to escape what typically would have been a large ST-elevation inferior myocardial infarction.
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