An Interesting Case of Vanishing Myocardial Infarction

Abstract

A 45 year old male came with complaints of chest pain since one day following alcohol intake. Patient evaluated initially at a hospital where electrocardiograph was taken which revealed ST elevation in leads V2 - V4 and loading dose was given subsequently and was subsequently refereed to our hospital. Electrocardiograph was repeated in our hospital which surprisingly showed no ST elevation. Patient was taken up for angiogram which shows proximal LAD occlusion. Achieving initial thrombolysis in myocardial infarction grade 2-3 flow in the infarct-related artery prior to primary percutaneous coronary intervention (PPCI) is commonly referred to as transient STEMI, or spontaneous reperfusion. This condition affects about 20% of patients with STEMI and is usually accompanied by a resolution or improvement of symptoms. It can delay the emergency need of angioplasty. Although there is no specific reason for spontaneous resolution of ST elevation in myocardial infarction, but there are few biomarkers, prognostic tools and potential therapeutic targets which help in spontaneous re-perfusion in a developing myocardial infarction.