Dilemma of localization of culprit vessel by electrocardiography in acute myocardial infarction.

Acute coronary syndrome (ACS) and electrocardiography showing ST elevation in Lead aVR>V1 are considered specific for left main coronary artery lesion and also suggest extensive anterior wall myocardial infarction. In this backdrop, we are presenting an incidental observation of an association of ST elevation in lead aVR>V1 in isolated proximal left circumflex lesion in the setting of ACS, who later underwent successful primary percutaneous coronary intervention.