Document Detail

Electrocardiographic prediction of left anterior descending coronary artery occlusion site in acute anterior myocardial infarction.
MedLine Citation:
PMID:  15024768     Owner:  NLM     Status:  MEDLINE    
The complications, therapy and prognosis are significantly determined by the exact location of occlusion site in left anterior descending (LAD) coronary artery in anterior acute myocardial infarction (AMI). This study assessed the role of Electrocardiogram (ECG) as a predictor of coronary artery occlusion site in anterior AMI. Sixty two patients of anterior AMI were divided into two groups according to the occlusion site in relation to first septal and first diagonal branches, proximal--group A and distal--group B. Their initial ECG were analyzed and interpreted. The number of patients having ST elevation in leads aVR and aVL (> or = 0.5 mm) were significantly higher in proximal group compared to distal ones (42.3% vs 2.8% and 73.1% vs 22.2%; p < 0.001). Similarly the number of patients having ST depression in inferior leads, II (> or = 1 mm), III (> or = 1 mm) and aVF (> or = 1 mm) were also significantly higher in proximal group (84.6% vs 22.2%, 88.5% vs 33.3% and 84.6% vs 22.2%; p < 0.001). The sensitivity of ST depression in inferior leads II (> or = 1 mm), III (> or = 1 mm) and aVF (> or = 1 mm) to predict the proximal lesion were 85.0%, 88.0% and 85.0% respectively, whereas specificity were 78.0%, 67.0% and 78.0% respectively. The ST elevation in a VR had 42.0% sensitivity and 97.0% specificity to predict proximal lesion. Similarly ST elevation in aVL (> or = 0.5 mm) had 73% sensitivity and 78% specificity. In anterior AMI, ST elevation in aVR, aVL and ST depression in inferior leads can predict the occlusion site in LAD proximal to first diagonal and first septal branch.
Rajendra Koju; Nazrul Islam; Afzalur Rahman; Khaled Mohsin; Ahtar Ali; Mazharul Islam; Chandeshwar Yadav
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nepal Medical College journal : NMCJ     Volume:  5     ISSN:  -     ISO Abbreviation:  Nepal Med Coll J     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2004-03-17     Completed Date:  2004-04-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101129937     Medline TA:  Nepal Med Coll J     Country:  Nepal    
Other Details:
Languages:  eng     Pagination:  64-8     Citation Subset:  IM    
Department of Cardiology, Dhulikhel Hospital, PO No. 11008, 011-661497, 011-661727, Dhaka, Bangladesh.
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MeSH Terms
Case-Control Studies
Coronary Artery Disease / diagnosis*
Middle Aged
Myocardial Infarction / diagnosis*
Predictive Value of Tests
Sensitivity and Specificity

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