Document Detail


Discriminating between right coronary artery and circumflex artery occlusion by using a noninvasive 18-lead electrocardiogram.
MedLine Citation:
PMID:  17192527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Differentiating occlusion of the circumflex branch of the left coronary artery (also called the circumflex artery) from occlusion of the right coronary artery is often difficult because either may be associated with a pattern of acute inferior myocardial infarction on the electrocardiogram. OBJECTIVES: To determine if an inexpensive 18-lead electrocardiogram can provide useful information in differentiating sites of coronary occlusion. METHODS: Continuous 18-lead electrocardiograms, including standard 12-lead, right ventricular, and posterior leads, were recorded in 38 and 50 subjects undergoing percutaneous coronary interventions in the right coronary artery and the circumflex artery, respectively. RESULTS: ST-segment elevation in the posterior leads was twice as frequent during occlusion of the circumflex artery as during right coronary occlusion (P < .001). ST-segment elevation in the right ventricular leads and inferior leads occurred more often during occlusion of the right coronary artery than during occlusion of the circumflex artery. ST-segment depression in lead aVL is highly suggestive of right coronary occlusion, whereas ST-segment elevation in posterior leads without depression of the ST segment in lead aVL is highly sensitive and specific for occlusion of the circumflex artery. CONCLUSIONS: ST-segment changes in the 18-lead electrocardiogram can be used to differentiate between occlusions of the circumflex artery and occlusions of the right coronary artery. Knowing which vessel is occluded before percutaneous coronary intervention can help in planning the procedure and recognizing when patients are at high risk for disturbances in conduction at the atrioventricular node.
Authors:
Shu-Fen Wung
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of critical care : an official publication, American Association of Critical-Care Nurses     Volume:  16     ISSN:  1062-3264     ISO Abbreviation:  Am. J. Crit. Care     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-28     Completed Date:  2007-03-20     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  9211547     Medline TA:  Am J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  63-71     Citation Subset:  IM; N    
Affiliation:
The College of Nursing, University of Arizona, Tucson, AZ 85721-0203, USA. shufen@nursing.arizona.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Arterial Occlusive Diseases / diagnosis*,  therapy
Coronary Vessels / pathology*
Diagnosis, Differential
Electrocardiography / instrumentation,  methods*
Electrodes
Female
Humans
Male
Myocardial Infarction / diagnosis*,  therapy
Grant Support
ID/Acronym/Agency:
R01 NR008092/NR/NINR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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