[Single vessel disease of the anterior interventricular branch as a cause of combined anterior and posterior wall infarct in comparison with 2-vessel disease of the RIVA and RCA].

Only few studies deal with the problem of an isolated stenosis of the left anterior descending coronary artery (LAD) leading to a combined anterior and inferior myocardial infarction in the ECG and VCG. In the present study patients with electrocardiographic signs of anterior and inferior myocardial infarction and either one-vessel disease of the LAD branch (n = 27; group I) or two-vessel disease including the LAD and the right coronary artery (RCA) (n = 29; group II) were investigated. Due to the anterior myocardial infarction present in all patients, unequivocal signs of posterior and posterolateral infarct location were missing in the ECG and VCG. There was a distinct variability with regard to Q-wave duration and amplitude in the inferior leads of the ECG and of the Q/R-relation in the scalar lead Y of the VCG (Frank-leads) in patients with isolated LAD disease when compared to those with combined LAD and RCA disease, but no reliable parameter was found in the ECG and VCG which allowed to allocate patients to one of the two groups. On the other hand, there were significant differences in hemodynamics and left ventricular function between the two groups. Group I patients showed a significantly higher left ventricular ejection fraction (mean 49 +/- 15%) than patients with two-vessel disease (group II) (mean 42 +/- 12%) (p less than 0.05). Left ventricular end-diastolic pressures at rest (13 +/- 7 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)