The purpose of this case repots are to evaluate the role of ST elevation in aVR lead and to make analysis between both cases. There are some atypical electrocardiogram (ECG) presentations which need prompt management in patient with ischemic clinical manifestation such as ST elevation in aVR lead. In this case study, we report a 68-year old woman with chief symptoms of shortness of breath and chest discomfort. She was diagnosed with cardiogenic shock, with Killip class IV, and TIMI score of 8. The second case is a 57-year-old man with typical chest pain at rest which could not be relieved with nitrate treatment. He was diagnosed with ST elevation in inferior and aVR lead, and occlusion in left circumflex artery (LCX). Both patients underwent primary percutaneous coronary intervention (PPCI). Subsequently, both cases presented remarkable clinical improvements and improved ST elevation myocardial infarction (STEMI) in aVR lead.

---

Laporan kasus ini bertujuan menilai peran ST elevasi di lead aVR dan manifestasi perbedaannya diantara dua kasus. Ada beberapa tanda elektrokardiogram (EKG) yang tidak khas yang membutuhkan manjemen segera pada pasien dengan manifestasi klinis iskemia seperti elevasi ST di sadapan aVR. Pada laporan ini kami, menyajikan seorang wanita, 68 tahun mengalami sesak napas dan tidak nyaman di dada, dan diagnosis syok kardiogenik dan edema paru, elevasi ST di anterior luas dan sadapan aVR, dan oklusi left artery descendent (LAD) dan left circumflex artery (LCX) dengan killip 4 dan skor thrombolysis in myocardial infarction (TIMI) 8. Kasus kedua, seorang pria, 57 tahun mengeluh nyeri dada khas saat istirahat, 2 jam sebelum ke RS. Tidak hilang dengan nitrat. elevasi ST di sadapan inferior dan aVR, dan oklusi di LCX. Kedua pasien dilakukan primary percutaneous coronary intervention (PPCI) dan mengalami perbaikan kondisi serta perbaikan ST elevation in Myocardial infarction (STEMI) di sadapan aVR.