Abstract
Electrocardiogram a widely available tool may predict infarct related artery in acute inferior wall myocardial infarction. Severity of ST segment elevation may correlate with proximity of lesion in right coronary artery. Patient with acute ST segment elevation inferior wall myocardial infarction who underwent coronary angiogram was studied. Differences in electrocardiogram among right coronary and left circumflex groups were evaluated. Severity of ST segments elevation in relation to site of lesion in right coronary was studied. The mean age of presentation was 59.52 ± 11.01 years. Total 36 (72%) were men. A total of 42 (84%) had lesion in right and 8 (16%) in left circumflex. Age, sex,diabetes,hypertension, smoking, dyslipidemia and physical activity showed no correlation with lesion in right or circumflex coronary artery. ST segment elevation in III>II (P=0.01), ST segment depression in AVL> I (P<0.01) and ST elevation in V4R (P=0.04), correlated with right coronary lesion. Sum of ST elevation in inferior leads were 10.90 ±1.30 mm for proximal, 7.38±1.19 mm for mid and 5.50± 0.53 mm for distal right coronary with significant correlation (P<0.01). Electrocardiogram was reliable tool to difference right and left circumflex lesion. Severity of sum of ST segment elevations in inferior leads correlated with the proximity of lesion in right coronary.
Highlights
Electrocardiogram a widely available tool may predict infarct related artery in acute inferior wall myocardial infarction
Ethical approval was taken from the Institutional Review Board (IRB) of National Academy of Medical Sciences (NAMS) and the informed consent was obtained from all the participants
All the participants needed to have had coronary angiogram (CAG) done either during the primary percutaneous intervention (PCI) or before discharge from hospital to be included in the study
Summary
Electrocardiogram a widely available tool may predict infarct related artery in acute inferior wall myocardial infarction. Severity of ST segment elevation may correlate with proximity of lesion in right coronary artery. Infarct related artery (IRA) of inferior MI can be right coronary artery (RCA) or left circumflex artery (LCX).[3] RCA supplies several important structures in heart, so they can be involved if IRA is RCA. Electrocardiogram (ECG) is a simple and available tool. Several ECG criteria has been recommended for the IRA prediction with variable results.[4,5] Predicting the site of occlusion in RCA by ECG is worthwhile as proximal occlusion is likely to cause larger myocardial damage
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