Myocardial infarction with Paradoxical ST-
segment elevation migration: a case study
Dublin Core
Title
Myocardial infarction with Paradoxical ST-
segment elevation migration: a case study
segment elevation migration: a case study
Subject
ST-segment migration, Limbs reversal, Wandering ST-segment elevation
Description
Abstract
Background ST-elevation myocardial infarction is a life-threatening condition and the electrocardiogram is an
essential tool for its prompt diagnosis. However, ST-segment elevation migration can occur due to several factors,
including lead misplacement, coronary vasospasm, thrombus migration, aortic dissection, and acute pericarditis.
Case presentation A 47-year-old man with chest pain whose electrocardiogram revealed ST-segment elevation
in different territories within one hour. The apparent ST-segment elevation migration was attributed to limb
lead reversal, as confirmed by the cardiac catheterization findings, which were consistent with the second
electrocardiogram.
Conclusions The accurate identification of ST-segment elevation is important to the cardiologist in order to
determine the culprit vessel. This case highlights the accidental electrocardiogram electrode misplacement can result
in misdiagnosis, which can be identified by recognizing unusual P-QRS pattern, using familiar-language electrode
labeling, and performing serial electrocardiogram reviews.
Keywords ST-segment migration, Limbs reversal, Wandering ST-segment elevation
Background ST-elevation myocardial infarction is a life-threatening condition and the electrocardiogram is an
essential tool for its prompt diagnosis. However, ST-segment elevation migration can occur due to several factors,
including lead misplacement, coronary vasospasm, thrombus migration, aortic dissection, and acute pericarditis.
Case presentation A 47-year-old man with chest pain whose electrocardiogram revealed ST-segment elevation
in different territories within one hour. The apparent ST-segment elevation migration was attributed to limb
lead reversal, as confirmed by the cardiac catheterization findings, which were consistent with the second
electrocardiogram.
Conclusions The accurate identification of ST-segment elevation is important to the cardiologist in order to
determine the culprit vessel. This case highlights the accidental electrocardiogram electrode misplacement can result
in misdiagnosis, which can be identified by recognizing unusual P-QRS pattern, using familiar-language electrode
labeling, and performing serial electrocardiogram reviews.
Keywords ST-segment migration, Limbs reversal, Wandering ST-segment elevation
Creator
Yu-An Chen1,3, Cheng-Chieh Huang1,2, Tsung-Han Lee1,2 and Yan-Ren Lin1,2,4*
Source
https://doi.org/10.1186/s12245-025-01090-0
Date
2025
Contributor
Peri Irawan
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Yu-An Chen1,3, Cheng-Chieh Huang1,2, Tsung-Han Lee1,2 and Yan-Ren Lin1,2,4*, “Myocardial infarction with Paradoxical ST-
segment elevation migration: a case study,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12925.
segment elevation migration: a case study,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12925.