Journal of Electrocardiology
Volume 36, Issue 1 , Pages 11-16, January 2003

Clinical utility of ST-segment depression in lead AVR in acute myocardial infarction☆

Division of Cardiac Sciences, University of Alberta, Grey Nuns Hospital, Edmonton, Alberta, Canada

Article Outline

Abstract 

The present study evaluated the prevalence and significance of ST-segment depression (STD) in lead aVR on the admission 12-lead electrocardiogram in 307 consecutive patients with an acute myocardial infarction (AMI) with ST-segment elevation. STD in aVR was present in a significantly higher proportion of patients with inferior/posterior AMIs. Within inferior/posterior AMIs those with STD in aVR had significantly more concomitant STD in V1, V2, V3 and more concomitant STesegment elevation in V5, V6 and right precordial leads. These data suggests that STD in aVR may point to a coronary artery with a large area of supply as the culprit vessel responsible for the AMI.

Keywords:  Electrocardiography, myocardial infarction, Pathophysiology, diagnostic techniques

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Reeder GS, Gersh BJ. Modern Management of acute myocardial infarction. Curr Prob Cardiol. 2000;25:683
  2. Yusuf S, Pearson M, Sterry H, et al.  The entry ECG in the early diagnosis and prognostic stratification of patients with suspected acute myocardial infarction. Eur Heart J. 1984;5:690
  3. Hathway W, Peterson C, Wagner G, et al.  Prognostic significance of the initial electrocardiogram in patients with acute myocardial infarction. J Am Med Ass. 1998;279:387
  4. Matetzky S, Freimark D, Chouraqui P, et al.  Significance of ST-segment elevations in posterior leads (V7 to V9) in patients with acute inferior myocardial infarction: Applications for thrombolytic therapy. J Am Coll Cardiol. 1998;31:506
  5. Kinch JW, Ryan TJ. Right ventricular infarction. N Eng J Med. 1994;330:1211
  6. The GUSTO Investigators . An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Eng J Med. 1993;329:673
  7. Senaratne MPJ, Irwin ME, Shaben S, et al.  Feasibilty of direct discharge from coronary/intermediate care unit after acute myocardial infarction. J Am Coll Cardiol. 1999;33:1040
  8. Hsu L, Senaratne MPJ, De Silva S, et al.  Prediction of coronary events following myocardial infarction using a discriminant function analysis. J Chronic Dis. 1986;39:543
  9. Klecka WR. Discriminant analysis. In: ed 2.  Nie NH,  Hull CH,  Jenkins JG, et al. editor. Statistical Package for the Social Sciences. New York, NY: , Mcgraw Hill; 1975;p. 434
  10. Assali AR, Herz I, Mordachai V, et al.  Electrocardiographic criteria for predicting the culprit artery in inferior wall acute myocardial infarction. Am J Cardiol. 1999;84:87
  11. Matetzky S, Freimark D, Feinberg MS, et al.  Acute myocardial infarction with isolated ST-segment elevation in posterior chest leads V7-9. J Am Cardiol. 1999;34:748
  12. Menown IBA, Adgey J. Improving the ECG classification of inferior and lateral myocardial infarction by inversion of lead aVR. Heart. 2000;83:657
  13. Cabin HS, Clubb KS, Wackers HJT, et al.  Right ventricular myocardial infarction with anterior wall myocardial infarction: An autopsy study. Am Heart J. 1987;113:16

☆ Reprint requests: Manohara P.J. Senaratne, FRCPC, FACC, PhD, Clinical Professor, Department of Medicine, University of Alberta, Director Coronary Care Unit, Grey Nuns Hospital, 1100 Youville Drive West, Edmonton, Alberta, Canada, T6L 5X8.

PII: S0022-0736(02)30452-7

doi:10.1054/jelc.2003.50001

Journal of Electrocardiology
Volume 36, Issue 1 , Pages 11-16, January 2003

Article Tools