Document Detail

Isolated inferior wall ST segment depression as an early sign of acute anterior wall myocardial infarction.
MedLine Citation:
PMID:  20954789     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Reciprocal changes may accompany ST segment elevation in the ischemic territory during acute myocardial infarction (AMI). We examined the hypothesis that isolated inferior ST segment depression on admission is an early sign of anterior wall infarction.
METHODS: 49 patients admitted to the coronary care unit between January 1996 and June 2008 who presented with inferior ST segment depression in the absence of ST segment elevation. Electrocardiograms (ECGs) obtained on admission and at 24-48 h were reviewed. Culprit artery was determined based on angiographic and echocardiographic data.
RESULTS: All patients had ST segment depression in the inferior leads on admission. A subgroup (55%) presented with concomitant ST segment depression in V5-V6. Follow-up ECG showed that 35% developed ST segment elevations and/or T wave inversions in anterior wall leads over 24-48 h. The left anterior descending (LAD) artery or one of its branches was the culprit in 60% of the patients. Sum of ST segment depression, V5-V6 involvement or presence of 'hyperacute' T waves did not predict LAD involvement.
CONCLUSION: Isolated ST segment depression in the inferior wall leads during ACS is usually an early sign of anterior wall AMI, in which the LAD or one of its branches is the culprit artery.
Iddo Bar-Yishay; Harel Gilutz; Carlos Cafri; Reuben Ilia; Doron Zahger
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Publication Detail:
Type:  Journal Article     Date:  2010-10-18
Journal Detail:
Title:  Acute cardiac care     Volume:  12     ISSN:  1748-295X     ISO Abbreviation:  Acute Card Care     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101276603     Medline TA:  Acute Card Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  119-23     Citation Subset:  IM    
Department of Cardiology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of Negev, Beer Sheva.
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MeSH Terms
Anterior Wall Myocardial Infarction* / diagnosis,  pathology,  physiopathology
Coronary Angiography
Coronary Care Units
Coronary Vessels / pathology
Early Diagnosis
Middle Aged
Retrospective Studies
Time Factors

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