Unusual presentation of right ventricular branch occlusion during percutaneous coronary intervention

Right ventricular (RV) infarction usually occurs in the setting of inferior wall myocardial infarction due to proximal right coronary artery (RCA) occlusion. A rarer cause of RV infarction involves an isolated RV branch occlusion during a percutaneous coronary intervention (PCI) to revascularize the RCA. In this case, the isolated RV branch occlusion resulted in transient unexpected ST-segment elevations in the anterior precordial leads. The patient developed transient chest pain peri-procedurally and repeat angiography showed widely patent stents but complete occlusion of the isolated RV branch. This case highlights a rare and unusual presentation of RV branch occlusion with anterior ST-segment elevations. Keywords: coronary artery disease, percutaneous coronary intervention, right ventricular infarction