<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0188-2198</journal-id>
<journal-title><![CDATA[Revista mexicana de cardiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Mex. Cardiol]]></abbrev-journal-title>
<issn>0188-2198</issn>
<publisher>
<publisher-name><![CDATA[Asociación Nacional de Cardiólogos de México, Sociedad de Cardiología Intervencionista de México]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0188-21982017000400200</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusion]]></article-title>
<article-title xml:lang="es"><![CDATA[Análisis electrocardiográfico de derivaciones V1-V4 en infarto por oclusión de la arteria coronaria derecha proximal]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Félix-Bulman]]></surname>
<given-names><![CDATA[Jorge Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Amador-Mena]]></surname>
<given-names><![CDATA[José Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Macías-Garrido]]></surname>
<given-names><![CDATA[Enrico]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,La Salle University Angeles Pedregal Hospital ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Angeles Pedregal Hospital  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<volume>28</volume>
<numero>4</numero>
<fpage>200</fpage>
<lpage>205</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0188-21982017000400200&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0188-21982017000400200&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0188-21982017000400200&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  In some cases, ST segment elevation in right precordial leads in conjunction with inferior leads can be originated by an obstruction of the right coronary artery in its proximal portion, generating an inferior myocardial infarction which involves the right ventricle.  Case presentation:  We present the case of a 57-year-old male, which presents symptoms of acute coronary syndrome. The electrocardiogram shows subepicardial injury in anteroseptal leads (V1-V3) and elevation of ST segment in inferior leads (DIII, AVF). A coronariography is performed finding a complete obstruction of right coronary artery in the proximal portion, left coronary artery without lesions.  Analysis:  In right ventricular infarction or anteroseptal infarction, the ST segment vector always has a posterior- anterior direction in horizontal plane, the direction of this vector will produce an elevation of ST segment in leads V1 to V3 (even V4).  Conclusion:  It is necessary to do a correct analysis of the electrocardiogram for understanding the mentioned changes and to not assume that the electrocardiographic manifestations are a consequence of multivessel disease.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  En algunos casos, la elevación del segmento ST en derivaciones precordiales derechas en conjunción con derivaciones inferiores, puede originarse por una obstrucción de la arteria coronaria derecha en su porción proximal, generando así un infarto de miocardio inferior que involucra al ventrículo derecho.  Presentación del caso:  Presentamos el caso de un paciente varón de 57 años, que presenta síntomas de síndrome coronario agudo, el electrocardiograma muestra lesión subepicárdica en derivaciones anteroseptales (V1-V3) y elevación del segmento ST en derivaciones inferiores (DIII, AVF). Una coronariografía se realiza encontrando una obstrucción completa de la arteria coronaria derecha en la porción proximal, arteria coronaria izquierda sin lesiones.  Análisis:  En el infarto ventricular derecho o infarto anteroseptal, el vector del segmento ST siempre tiene una dirección posterior-anterior en el plano horizontal, la dirección de este vector producirá una elevación del segmento ST en las derivaciones V1 a V3 (incluso V4).  Conclusión:  Es necesario hacer un análisis correcto del electrocardiograma para comprender los cambios mencionados y no asumir que las manifestaciones electrocardiográficas son consecuencia de la enfermedad multivaso.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Infarct]]></kwd>
<kwd lng="en"><![CDATA[electrocardiogram]]></kwd>
<kwd lng="en"><![CDATA[elevation]]></kwd>
<kwd lng="en"><![CDATA[vector]]></kwd>
<kwd lng="es"><![CDATA[Infarto]]></kwd>
<kwd lng="es"><![CDATA[electrocardiograma]]></kwd>
<kwd lng="es"><![CDATA[elevación]]></kwd>
<kwd lng="es"><![CDATA[vector]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carnicer]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Síndromes coronarios agudos con elevación simultánea del segmento ST en derivaciones inferiores y precordiales]]></article-title>
<source><![CDATA[Med Intensiva]]></source>
<year>2006</year>
<volume>30</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>143-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Geft]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Shah]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Hulse]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Maddahi]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Berman]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ST elevations in leads V1 to V5 may be caused by right coronary artery occlusion and acute right ventricular infarction]]></article-title>
<source><![CDATA[Am J Cardiol]]></source>
<year>1984</year>
<volume>53</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>991-6</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Serge]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Crawford]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Advanced 12- lead electrocardiography]]></article-title>
<source><![CDATA[Cardiol Clin]]></source>
<year>2006</year>
<volume>24</volume>
<page-range>343-65</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Domínguez]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
<name>
<surname><![CDATA[Arias]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[En cardiopatía isquémica ¿es la elevación del segmento ST en cara anterior sinónimo de infarto agudo de miocardio anterior de ventrículo izquierdo?]]></article-title>
<source><![CDATA[Rev Clin Esp]]></source>
<year>2010</year>
<volume>210</volume>
<page-range>92-3</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Muhammad]]></surname>
<given-names><![CDATA[KI]]></given-names>
</name>
<name>
<surname><![CDATA[Kapadia]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anterior ST-segment elevation with right coronary artery occlusion a unique case of isolated right ventricular infarction]]></article-title>
<source><![CDATA[Angiology]]></source>
<year>2008</year>
<volume>59</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>622-4</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Porter]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Herz]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Strasberg]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Isolated right ventricular infarction presenting as anterior wall myocardial infarction on electrocardiography]]></article-title>
<source><![CDATA[Clin Cardiol]]></source>
<year>1997</year>
<volume>20</volume>
<page-range>971-3</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pozas]]></surname>
<given-names><![CDATA[GG]]></given-names>
</name>
<name>
<surname><![CDATA[Valdés]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[Ibarra]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El método de Grant]]></article-title>
<source><![CDATA[Revista AVANCES]]></source>
<year>2012</year>
<volume>27</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>18-22</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sidhu]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Aggarwal]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Fay]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute isolated right ventricular myocardial infarction masquerading as acute anterior myocardial infarction]]></article-title>
<source><![CDATA[BMJ Case Rep]]></source>
<year>2014</year>
<volume>014</volume>
<numero>2014</numero>
<issue>2014</issue>
<page-range>bcr2012008087</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Robalino]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Whitlow]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Underwood]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Salcedo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Electrocardiographic manifestations of right ventricular infarction]]></article-title>
<source><![CDATA[Am Heart J]]></source>
<year>1989</year>
<volume>118</volume>
<page-range>138-44</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hurst]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comments about the electrocardiographic signs of right ventricular infarction]]></article-title>
<source><![CDATA[Clin Cardiol]]></source>
<year>1998</year>
<volume>21</volume>
<page-range>289-91</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carroll]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Butt]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hussain]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Unusual electrocardiographic presentation of an isolated right ventricular myocardial infarction secondary to thrombotic occlusion of a non-dominant right coronary artery a case report and brief review of literature]]></article-title>
<source><![CDATA[Angiology]]></source>
<year>2003</year>
<volume>54</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>119-24</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sadanandan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hochman]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Kolodziej]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Criger]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Ross]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Selvester]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical and angiographic characteristics of patients with combined anterior and inferior ST-segment elevation on the initial electrocardiogram during acute myocardial infarction]]></article-title>
<source><![CDATA[Am Heart J]]></source>
<year>2003</year>
<volume>146</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>653-61</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
