Document Detail

Utility of ST segment depression in lead AVL in the diagnosis of right ventricular infarction.
MedLine Citation:
PMID:  14679604     Owner:  NLM     Status:  MEDLINE    
We performed twelve lead electrocardiograms(ECG) and right precordial leads on twenty-two consecutive patients with first inferior wall acute myocardial infarction (MI) diagnosed by classical Q waves and elevation of cardiac enzymes. The presence of right ventricular MI was established by either technetium 99 (TC-99) pyrophosphate scanning or 2-dimensional (2-D) echocardiography by observers unrelated to the study and not aware of the electrocardiographic findings. In patients with established right ventricular MI (n = 15/22), ST segment elevation > or = 0.1 mV in lead V4R placed in the right precordial lead position had 91% (10/11) sensitivity in diagnosing right ventricular MI. ST segment depression in lead AVL > or = 0.1 mV had 100% sensitivity in diagnosing right ventricular MI (15/15). In the seven patients without right ventricular infarction, the absence of ST segment elevation in lead V4R had 100% specificity (7/7), while the absence of ST segment depression in lead AVL had 57% specificity (4/7) in excluding right ventricular infarction. The data indicate that in the presence of inferior wall MI, ST segment depression in lead AVL is a sensitive, but not very specific sign of right ventricular MI. Therefore, its presence in patients with inferior wall MI should lead to further investigations to diagnose or exclude right ventricular MI.
David L Rashduni; Alan K Tannenbaum
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  New Jersey medicine : the journal of the Medical Society of New Jersey     Volume:  100     ISSN:  0885-842X     ISO Abbreviation:  N J Med     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-12-18     Completed Date:  2004-02-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8511653     Medline TA:  N J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  35-7     Citation Subset:  IM    
UMDNJ-Robert Wood Johnson Medical School, Division of Cardiovascular Diseases and Hypertension, USA.
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MeSH Terms
Heart Ventricles / physiopathology
Middle Aged
Myocardial Infarction / diagnosis*
Predictive Value of Tests
Ventricular Dysfunction, Right / diagnosis*

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