Wandering ST-Segment Elevation

A 52-year-old man with a history of surgical repair of an abdominal aortic aneurysm 9 years earlier had a sudden onset of chest and back pain. His primary physician diagnosed acute myocardial infarction on the basis of ST elevation in leads V2 and V3 (Figure 1A). ST segments in leads I and aVL became elevated 30 minutes later, when chest pain worsened (Figure 2B). On arrival at our hospital, the patient had a blood pressure of 70/50 mm Hg in both arms and a heart rate of 54 bpm. Both femoral and dorsal arteries …