Journal of Electrocardiology
Volume 43, Issue 2 , Pages 132-135 , March 2010

ST-segment depression in aVR as a predictor of culprit artery and infarct size in acute inferior wall ST-segment elevation myocardial infarction

  • Yumiko Kanei, MD

      Affiliations

    • Division of Cardiology, Department of Medicine, Beth Israel Medical Center, New York, NY, USA
    • Corresponding Author InformationCorresponding author. Cardiac Catheterization Laboratory, Beth Israel Medical Center, 11 Dazian, 1st Avenue at 16th Street, New York, NY 10003.
    • ,
  • Jyoti Sharma, MD

      Affiliations

    • Department of Medicine, Beth Israel Medical Center, New York, NY, USA
    • ,
  • Ravi Diwan, MD

      Affiliations

    • Department of Medicine, Beth Israel Medical Center, New York, NY, USA
    • ,
  • Ron Sklash, MD

      Affiliations

    • Department of Medicine, Beth Israel Medical Center, New York, NY, USA
    • ,
  • Lori L. Vales, MD

      Affiliations

    • Division of Cardiology, Department of Medicine, Beth Israel Medical Center, New York, NY, USA
    • ,
  • John T. Fox, MD

      Affiliations

    • Division of Cardiology, Department of Medicine, Beth Israel Medical Center, New York, NY, USA
    • ,
  • Paul Schweitzer, MD

      Affiliations

    • Division of Cardiology, Department of Medicine, Beth Israel Medical Center, New York, NY, USA

Received 29 June 2009

References 

  1. Kosuge M, Kimura K, Ishikawa T, et al. New electrocardiographic criteria for predicting the site of coronary artery occlusion in inferior wall acute myocardial infarction. Am J Cardiol. 1998;82:1318
  2. Chia BL, Yip JW, Tan HC, Lim TY. Usefulness of ST elevation II/III ratio and ST deviation in lead I for identifying the culprit artery in inferior wall acute myocardial infarction. Am J Cardiol. 2000;86:341
  3. Herz I, Assali AR, Adler T, Solodky A, Sclarovsky S. New electrocardiographic criteria for predicting either the right or left circumflex artery as the culprit coronary artery in inferior wall acute myocardial infarction. Am J Cardiol. 1997;80:1343
  4. Zimetbaum PJ, Krishnan S, Gold A, Carrozza JP, Josephson ME. Usefulness of ST-segment elevation in lead III exceeding that of lead II for identifying the location of the totally occluded coronary artery in inferior wall myocardial infarction. Am J Cardiol. 1998;81:918
  5. Bairey CN, Shah PK, Lew AS, Hulse S. Electrocardiographic differentiation of occlusion of the left circumflex versus the right coronary artery as a cause of inferior acute myocardial infarction. Am J Cardiol. 1987;60:456
  6. Hasdai D, Birnbaum Y, Herz I, Sclarowsky S, Mazur A, Solodky A. ST segment depression in lateral limb leads in inferior wall acute myocardial infarction. Eur Heart J. 1995;16:1549
  7. Assali AR, Herz I, Vaturi M, et al. Electrocardiographic criteria for predicting the culprit artery in inferior wall acute myocardial infarction. Am J Cardiol. 1999;84:87
  8. Fiol M, Cygankiewicz I, Carrillo A, et al. Value of electrocardiographic algorithm based on “ups and downs” of ST in assessment of a culprit artery in evolving inferior wall acute myocardial infarction. Am J Cardiol. 2004;89:709
  9. Tierala I, Nikus KC, Sclarovsky S, Syvanne M, Eskola M. Predicting the culprit artery in acute ST-elevation myocardial infarction and introducing a new algorithm to predict infarct-related artery in inferior ST-elevation myocardial infarction : correlation with coronary anatomy in the HAAMU Trial. J Electrocardiol. 2009;42:120
  10. Menown IBA, Adgey AAJ. Improving the ECG classification of inferior and lateral myocardial infarction by inversion of lead aVR. Heart. 2000;83:657
  11. Nair B, Glancy L. ECG Discrimination between right and left circumflex coronary arterial occlusion in patients with acute inferior myocardial infarction. Chest. 2002;122:134
  12. Sun TW, Wang LX, Zhang YZ. The value of ECG lead aVR in the differential diagnosis of acute inferior wall myocardial infarction. Intern Med. 2007;46:795
  13. Kosuge M, Kimura K, Ishikawa T, et al. ST-segment depression in lead aVR. Chest. 2005;128:780
  14. Zhong-Qun Z, Wei W, Shu-Yi D, Chong-Quan W, Jun-Feng Wang , Zheng Cao . Electrocardiographic characteristics in angiographically documented occlusion of the dominant left circumflex artery with acute inferior myocardial infarction: limitations of ST elevation III/II ratio and ST deviation in lateral limb leads. J Electrocardiol. 2009;[Electronic publication ahead of print]
  15. Huey BL, Beller GA, Kaiser DL, Gibson RS. A comprehensive analysis of myocardial infarction due to left circumflex artery occlusion: comparison with infarction due to right coronary artery and left anterior descending artery occlusion. J Am Coll Cardiol. 1988;12:1156

PII: S0022-0736(09)00423-3

doi: 10.1016/j.jelectrocard.2009.09.003

Journal of Electrocardiology
Volume 43, Issue 2 , Pages 132-135 , March 2010

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