Electrocardiographical case. Beware of this ECG in patients presenting with cardiogenic shock.

A 64-year-old Chinese man presented to the Accident and Emergency Department with chest pain and was found to be in cardiogenic shock. The electrocardiogram (ECG) showed features of acute myocardial infarction due to left main coronary artery occlusion,which had no ST elevation in precordial leads. Emergency coronary angiogram revealed left main coronary artery complete occlusion. Percutaneous intervention of the left main coronary artery was carried out. The epidemiology and clinical features of a left main occlusion were briefly described, and ECG features of a left main occlusion were discussed.