Three-dimensional relationship between the conus branch and the precordial leads confirmed by 64–multidetector-row computed tomography

A 65-year–old man with effort angina pectoris underwent percutaneous coronary intervention of the proximal right coronary artery. The lesion was dilated with a bare-metal stent under wire protection of the conus branch (CB). However, the jailed CB was occluded. Electrocardiogram with conventional precordial leads (V1 through V6) accompanied with the supplementary leads (V1⁎ through V6⁎) positioned 1 intercostal space higher showed marked ST elevation in V1 through V3 that was more prominent in V1⁎ through V3⁎. The 64–multidetector-row computed tomographic coronary angiography showed recanalization of the CB located just in the center of the V1⁎, V2⁎, V1, and V2 electrodes.