A patient is described who sustained a cardiac stab wound which was associated with ECG evidence of a full thickness myocardial infarction. Subsequent investigation showed a localized area of dyskinesia on left ventricular angiography, but normal thallium myocardial perfusion and normal anatomy on coronary angiography. The patient was managed conservatively and made a complete and uneventful recovery. It is concluded that extensive ECG changes following a cardiac stab wound need not be associated with major coronary artery damage.
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