A 55-year-old man was referred to our department with antero-septo-apical ST-elevation myocardial infarction ( Fig. 1 Panel A ). No history (personal or family) was reported, except a smoking habit. The patient received thrombolytic therapy 1 h after symptom onset. Twenty minutes later, early signs of reperfusion were sudden relief of chest pain and accelerated idioventricular rhythm followed by ST-segment normalization ( Fig. 1 Panels B and C). The patient underwent angioplasty of the proximal left descending coronary artery with a bare-metal stent ( Fig. 2 Panel D ). Left ventriculography showed severe antero-apical hypokinesia ( Fig. 2 Panel E; Video 1 ). Troponin T concentration was raised to 0.8 ng/mL (N ≤ 0.01 ng/mL).
Panel A. Initial electrocardiogram (ECG) showing antero-septo-apical ST-segment elevation with ST-segment depression in the inferior leads. Panel B. Twenty minutes after the start of thrombolytic therapy, ECG showed accelerated idioventricular rhythm. Panel C. Forty minutes later, ECG showed complete resolution of ST-segment elevation after thrombolysis.
