Document Detail

Value of lead V4R for recognition of the infarct coronary artery in acute inferior myocardial infarction.
MedLine Citation:
PMID:  6731298     Owner:  NLM     Status:  MEDLINE    
In 84 patients with an acute inferior wall myocardial infarction (MI) admitted within 10 hours after the onset of chest pain, a right precordial lead V4R electrocardiogram was recorded in addition to the standard 12-lead electrocardiogram. The presence or absence of ST-segment elevation in lead V4R was correlated with results of coronary angiography performed 2 to 26 weeks (mean 10) after MI. Patients were classified into 3 groups: (1) those with a critical stenosis or occlusion proximal to the first right ventricular (RV) branch (27 patients); (2) those with stenosis distal to the right ventricular branch of the right coronary artery (36 patients); and (3) those with stenosis in the left circumflex coronary artery (21 patients). The presence of ST-segment elevation greater than or equal to 1 mm in lead V4R has a sensitivity of 100% and a specificity of 87% for occlusion of the right coronary artery above the first RV branch; the predictive accuracy is 92%. Seven of 36 patients with a distal occlusion of the right coronary artery showed ST-segment elevation of 1 mm or more in lead V4R . The absence of ST-segment elevation greater than or equal to 1 mm in lead V4R excluded proximal occlusion of the right coronary artery. ST-segment elevation in lead V4R was not seen either in 29 of 36 patients with a distal occlusion of the right coronary artery or in all patients with an occlusion of the left circumflex artery. Recording of lead V4R within 10 hours after onset of acute inferior wall MI can give information rapidly about the vessel responsible for MI.(ABSTRACT TRUNCATED AT 250 WORDS)
S H Braat; P Brugada; K den Dulk; V van Ommen; H J Wellens
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  53     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1984 Jun 
Date Detail:
Created Date:  1984-07-03     Completed Date:  1984-07-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1538-41     Citation Subset:  AIM; IM    
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MeSH Terms
Coronary Angiography
Coronary Vessels / pathology*
Middle Aged
Myocardial Infarction / pathology,  physiopathology*,  radiography

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