Value of electrocardiogram (ECG) in identifying acute occlusion sites of right coronary artery

Abstract

Clinical data of 151 patients with acute occlusion of right coronary artery were retrospectively analyzed. Coronary angiography and electrocardiography (EEG) were performed in all 151 patients, angiography showed proximal-middle segment occlusion in 114 cases and distant segment occlusion in 37 cases. The correlation of ECG findings with coronary artery occlusion sites was analyzed. Results showed that EEG findings related to proximal-middle segment occlusion were: ST segment elevation in lead V4R ≥0.05 mV, Ⅲ degree atrioventricular block, ST segment depression in lead Ⅰ>0.1 mV, ST segment depression in lead AVL≥0.2 mV, ST segment elevation in lead Ⅲ≥0.25 mV, the total ST depression in lead V2,V3 and V4 ≥0.4 mV , the total ST depression in lead I and aVL ≥0.25 mV; among which ST depression of Lead Ⅰ>0.1 mV, ST elevation of Lead V4R≥0.05 mV and Ⅲ degree atrioventricular block were used to predict occlusion of proximal-middle segment of right coronary artery with 100% specificity. ECG findings related to distal segment occlusion were: ST depression in lead Ⅰ≤0.1 mV, ST segment depression in lead AVL<0.2 mV, ST elevation in lead Ⅲ≤0.25 mV, the total ST depression in lead V2,V3 and V4 <0.4 mV, ST segment were not depression in lead V1-V5,the total ST depression in lead I and aVL<0.25 mV. Based on a 4-step flow method, ECG might be adopted to identify the acute occlusion sites in proximal-middle segment and distal segment of right coronary. Key words: Coronary occlusion; Inferior wall myocardial infarction; Electrocardiography