Simkhada Rabindra
Department of Cardiology, National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2013 Jul-Sep;52(191):453-6.
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.
