Abstract
Background and aims: Electrocardiogram of acute ST elevation inferior myocardial infarction can show concomitant ST depression in anterior leads. We aimed to see its significance on coronary angiogram. Methods: Cross sectional study conducted in Department of Cardiology of Shahid Gangalal National Heart Centre from March 2021 to June 2021. Total of 64 patients of acute inferior myocardial infarction were included consecutively. Electrocardiogram were analyzed for the presence of ST depression in anterior leads (V1-V6). Coronary angiogram were obtained. Linear regression analysis was applied to see correlations. Results: Thirty-four (53.12%) participants had significant ST depression in anterior leads. Their mean age was 64.53±11.67 years. Twenty-two (64.70%) were male. Out of them, 13 (38.23%) were hypertensive, 9 (26.47%) were smoker and 7 (20.58%) were diabetic. Among 30 (46.88%) participants without ST depression, mean age was 56.73±13.31 years and 21 (70%) were male. Out of them, 11 (36.66%) were hypertensive, 12 (40%) were smoker and 11 (33.66%) were diabetic. Culprit vessel was right coronary artery in 22 (64.70%) of those with ST depression and 22 (73.33%) of those without ST depression. Significant left anterior descending artery lesion was seen in 19 (55.88%) of those with ST depression and 3 (10%) of those without depression. Anterior ST depression showed positive correlation with left anterior descending artery lesion. Conclusion: ST depression in anterior leads in acute inferior myocardial infarction can be due to presence of concomitant left anterior descending coronary artery disease.
Highlights
Acute ST elevation myocardial infarction (STEMI) is one of the major public health problem in both industrialized and developing world and is the important cause of morbidity and mortality worldwide.[1]
Variations exists on the angiographic significance as well as on the prevalence of traditional risk factors of those with anterior ST depression in acute inferior STEMI in previous studies done in various settings.[2,3]
Since ECG is a very important and readily available tool for diagnosis of MI, understanding the significance of ST depression in anterior leads in inferior MI with reference to coronary angiogram (CAG) would help in better understanding of the disease
Summary
Acute ST elevation myocardial infarction (STEMI) is one of the major public health problem in both industrialized and developing world and is the important cause of morbidity and mortality worldwide.[1]. An electrocardiogram (ECG) of acute inferior STEMI shows ST elevation in inferior leads and can show ST depression in anterior leads (V1-V6). Variations exists on the angiographic significance as well as on the prevalence of traditional risk factors of those with anterior ST depression in acute inferior STEMI in previous studies done in various settings.[2,3] Some studies have shown that presence of anterior ST depression can be more symptomatic, can have higher severity of the disease and increased mortality but others reported almost similar prognosis.[4,5,6] Since ECG is a very important and readily available tool for diagnosis of MI, understanding the significance of ST depression in anterior leads in inferior MI with reference to coronary angiogram (CAG) would help in better understanding of the disease.
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