Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 17, Number 3, March 2026, pages 81-86

Silence of the Electrocardiogram: A Case Series With Occluded Coronaries and Normal Electrocardiograms

Figures

Figure 1.
Figure 1. (a) EKG showing sinus rhythm with no acute ischemic changes. (b) Left anterior oblique caudal view showing right coronary artery. (c) Left anterior oblique caudal view showing complete occlusion of left circumflex artery (red arrow). (d) Post-PCI perfusion of the left circumflex artery (red arrow). EKG: electrocardiogram; PCI: percutaneous coronary intervention.
Figure 2.
Figure 2. (a) EKG showing normal sinus rhythm with no acute ischemic changes. (b) Left anterior oblique caudal view showing early-mid-RCA with moderate nonobstructive disease. (c) Left anterior oblique caudal view indicating complete occlusion of OM 100% occlusion, as well as mid-LAD moderate disease (red arrow). (d) Left anterior oblique caudal view showing post-PCI perfusion of OM1 (red arrow). EKG: electrocardiogram; RCA: right coronary artery; LAD: left anterior descending artery; OM: obtuse marginal artery; PCI: percutaneous coronary intervention.
Figure 3.
Figure 3. (a) EKG showing normal sinus rhythm with no ischemic changes. (b) Right anterior oblique caudal view showing normal RCA. (c) Coronary angiography indicating 90% proximal ramus intermedius stenosis (red arrow). (d) Left anterior oblique caudal view post-PCI perfusion of ramus intermedius (red arrow). EKG: electrocardiogram; RCA: right coronary artery; LAD: left anterior descending artery; OM: obtuse marginal artery; PCI: percutaneous coronary intervention.