PMID- 30109032 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20200930 IS - 2053-8855 (Print) IS - 2053-8855 (Electronic) IS - 2053-8855 (Linking) VI - 2018 IP - 8 DP - 2018 Aug TI - 'Balanced ischaemia' on ECG in dual territory STEMI. PG - omy043 LID - 10.1093/omcr/omy043 [doi] LID - omy043 AB - Culprit lesion identification in ST elevation myocardial infarction (STEMI) is often guided by electrocardiogram (ECG) changes. However, in the setting of multi-vessel coronary artery occlusion, this can be challenging. We describe an interesting case of dual territory STEMI with unanticipated ECG changes that bring forth the concept of 'balanced ischaemia'. These seemingly bizarre findings are well explained using the fundamentals of electrocardiography reinstating its relevance in modern day cardiology. FAU - Balakrishnan, Iswaree Devi AU - Balakrishnan ID AD - Department of Cardiology, National Heart Centre, Singapore, Singapore. FAU - Chin, Chee Yang AU - Chin CY AD - Department of Cardiology, National Heart Centre, Singapore, Singapore. FAU - Teo, Louis AU - Teo L AD - Department of Cardiology, National Heart Centre, Singapore, Singapore. FAU - Tan, Boon Yew AU - Tan BY AD - Department of Cardiology, National Heart Centre, Singapore, Singapore. FAU - Yeo, Khung Keong AU - Yeo KK AD - Department of Cardiology, National Heart Centre, Singapore, Singapore. LA - eng PT - Case Reports DEP - 20180809 PL - England TA - Oxf Med Case Reports JT - Oxford medical case reports JID - 101642070 PMC - PMC6084609 EDAT- 2018/08/16 06:00 MHDA- 2018/08/16 06:01 PMCR- 2018/08/09 CRDT- 2018/08/16 06:00 PHST- 2018/02/04 00:00 [received] PHST- 2018/04/15 00:00 [revised] PHST- 2018/05/19 00:00 [accepted] PHST- 2018/08/16 06:00 [entrez] PHST- 2018/08/16 06:00 [pubmed] PHST- 2018/08/16 06:01 [medline] PHST- 2018/08/09 00:00 [pmc-release] AID - omy043 [pii] AID - 10.1093/omcr/omy043 [doi] PST - epublish SO - Oxf Med Case Reports. 2018 Aug 9;2018(8):omy043. doi: 10.1093/omcr/omy043. eCollection 2018 Aug.