Electorocardiographic changes in acute myocadial infarction due to left main coronary artery occulusion. Efficacy of lead aVR

Abstract

We evaluated the relationship between ST segment elevation in lead aVR and the coronary circulation in acute antero septal myocardial infarction. All eightynine patients were admitted to the coronary care unit within twelve hours and received emergency coronary angiography. The infarct-related artery (LAD or LMT) was occuluded in all patients. Thirteen patients had total occulusion in left main coronaly artery. Nine patients had three vessels disease. Twentytwo patients had two vessels disease. Forty-five patients had one vessel disease. Twelve lead electrocardiogram was recorded before emergency coronary angiography. The ST segment elevation in lead aVR was found in 92% patients of left main coronary artery occulusion,44%of three vessels disease and 27% of two vessels disease but only one patients (2%) of one vessel disease.
Thus, ST elevation in lead aVR in acute anteroseptal myocardial infarction indicates severe impairments of the overall coronary circulation. Particulary ST segment elevation in lead aVR is good sign when acute myocardial infarction occured in left main coronary artery