Ingrid Rojas-Chaverra, Servicio de Cardiología, Clínica Universitaria Colombia, Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, Colombia
Silvia Rueda-Cataño, Servicio de Medicina Interna, Clínica Universitaria Colombia, Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, Colombia
Nelson Moreno-Ruiz, Servicio de Cardiología, Clínica Universitaria Colombia, Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, Colombia
ST-segment elevation myocardial infarction is part of the spectrum of acute coronary syndrome, in which complete obstruction of the culprit vessel leads to impaired perfusion of a specific myocardial territory, manifested as changes in the electrocardiographic tracing. One of the associated morphologies is the tombstone sign, which is typically observed in anterior wall infarctions. However, this report documents two cases where this finding is seen in inferior wall infarction, associated with electrical complications and systolic dysfunction due to significant myocardial involvement. Early recognition of this pattern allows for the initiation of timely and aggressive treatment to reduce adverse outcomes.
Keywords: ST segment elevation myocardial infarction. Acute coronary syndrome. Electrocardiography.