American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2021, 9(3), 201-205
DOI: 10.12691/ajmcr-9-3-17
Open AccessCase Report

Ventricular Tachycardia with ST Elevation in Lead aVR Associated with Normal Coronary Arteries: A Case Report and Review of Literature

Pramod Theetha Kariyanna1, Harshith Priyan Chandrakumar2, Ruchi Yadav3, Amog Jayarangaiah4, Apoorva Jayaranagaiah5, Rafsan Ahmed2, Debora Ponce2 and Samy I. McFarlane2,

1Division of Interventional Cardiology, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Morningside/Beth Israel Hospitals, New York City, NY-10025, U.S.A.

2Department of Internal Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, NY 11203, U.S.A.

3Department of Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, NY 11212, U.S.A.

4Trinity School of Medicine, 925 Woodstock Road, Roswell, GA 30075, U.S.A.

5Department of Internal Medicine, Albert Einstein College of medicine/ Jacobi Medical Center, Bronx, N.Y., U.S.A.

Pub. Date: January 14, 2021

Cite this paper:
Pramod Theetha Kariyanna, Harshith Priyan Chandrakumar, Ruchi Yadav, Amog Jayarangaiah, Apoorva Jayaranagaiah, Rafsan Ahmed, Debora Ponce and Samy I. McFarlane. Ventricular Tachycardia with ST Elevation in Lead aVR Associated with Normal Coronary Arteries: A Case Report and Review of Literature. American Journal of Medical Case Reports. 2021; 9(3):201-205. doi: 10.12691/ajmcr-9-3-17


As per the 2013 guidelines of ACCF/AHA (American College of Cardiology Foundation/ American Heart Association), ST Elevation (STE) in lead augmented vector right (aVR), along with ST depression in multiple leads, is associated with critical stenosis of left main coronary artery (LMCA), left anterior descending artery (LAD) or a triple vessel disease (TVD). Early identification of ST-Elevation Myocardial Infarction (STEMI) is important as timely reperfusion with intervention can save myocardium and improve survival. We present a case of a 70 years old female, with cardiovascular risk factors, who presented to the emergency department with chest pain decompensating with ventricular tachycardia. On cardioversion, she was found to have ST elevation in aVR with ST depression in V4-V6, I, II, and aVL. However subsequent echocardiogram and coronary angiogram showed normal coronary arteries and left ventricular function.

coronary angiography Augmented vector right (aVR) Electrocardiogram (ECG) criteria ST elevation myocardial infarction (STEMI) left anterior descending artery (LAD) left main coronary artery (LMCA)

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