Power Outage: Acute Subtotal Occlusion of the Left Circumflex Artery with Minimal ECG Changes

Acute coronary syndrome (ACS) represents one of the most recognizable causes of death in the United States. Despite significant advances in cardiovascular preventative health, an American will have a myocardial infarction approximately every 40 seconds.1 Fortunately, rapid diagnosis and treatment of ACS have allowed for significant reductions in both morbidity and mortality of myocardial infarctions.2 Thus, prompt identification of ACS is crucial, and nonetheless, it can still present a noteworthy challenge to physicians. In this case, we present a near-electrically silent acute thrombotic coronary subtotal occlusion. It constitutes a stark reminder that diagnosis of an acute myocardial infarction extends beyond the electrocardiogram (ECG).