We report the case of a 73-year-old male admitted for epigastric pain and syncope with increased troponin level and a rare electrocardiogram (a single‑lead ST-elevation). Coronary angiography showed multi-vessel coronary artery disease. The patient underwent coronary angioplasty with drug-eluting stenting on left anterior descending coronary artery and drug eluting ballooning on first diagonal ostium. Coronary revascularization was completed with a staged stenting on left circumflex artery and right coronary artery.

In rare cases of acute coronary syndrome, even isolated ST single lead anomalies may underlie multivessel coronary disease.

我们报道了一名 73 岁男性因上腹疼痛和晕厥入院的病例，伴有肌钙蛋白水平升高和罕见的心电图（单导联 ST 段抬高）。冠状动脉造影显示多支冠状动脉疾病。该患者接受了冠状动脉血管成形术，在左冠状动脉前降支上放置药物洗脱支架，并在第一对角线口放置药物洗脱球囊。通过在左回旋动脉和右冠状动脉上分阶段支架置入完成冠状动脉血运重建。

在罕见的急性冠状动脉综合征病例中，即使是孤立的 ST 单导联异常也可能是多支冠状动脉疾病的基础。