Acute ECG ST-segment elevation as infero-lateral myocardial infarction in a patient with pulmonary embolism

Pulmonary embolism and ST-elevation myocardial infarction are both common causes of cardiovascular emergency which may rapidly lead to hemodynamic deterioration. A 70-year-old female brought to emergency department in cardiac arrest. The electrocardiogram (ECG) revealed sinus rhythm with right bundle branch block, ST-elevations in inferolateral leads. Her coronary angiogram showed non-obstructive coronary artery disease with a few plaques. A CT pulmonary angiogram showed subtotal occlusion of left main pulmonary artery and multiple fi lling defects on bilateral pulmonary distal segments. This report emphasizes that acute PE should be suspected in every patient with ST-elevation myocardial infarction and normal coronary arteries