[Estimate of the artery responsible for acute inferior myocardial infarct attack using arterial electrocardiograph tracings].
OBJECTIVE
The aim of the study was to determine IRA (infarct-related artery) by analysis of the initial ECG (electrocardiogram) in patients with acute inferior wall myocardial infarction.


METHODS
Forty patients (36 male, 4 female) admitted to coronary care unit with the diagnosis of acute inferior wall myocardial infarction were included in the study. The mean age of patients was 62.2 year (29-85 years). The coronary angiography was performed in all patients at the first week of admission. To determine the relationship between IRA and R/S ratio, ST segment depression in lead aVL, statistical analysis was performed.


RESULTS
IRA was the right coronary artery (RCA) in 20 cases, circumflex artery (Cx) in 15 cases, RCA + Cx in 5 cases. R/S ratio was bigger than one in patients with Cx lesion and R/S ratio was smaller than one in patients with RCA lesion. The degree of the ST segment depression was equal or smaller than 2 mm in patients with Cx lesion and greater than 2 mm in patients with RCA lesion (p < 0.05). There was no correlation between IRA and precordial reciprocal electrocardiographic changes. Diagnosis of right ventricular infarction was established in 75% of patients with RCA lesion, 26% of patients with Cx lesion and 100% of patients with RCA + Cx lesions.


CONCLUSIONS
We concluded that it was possible to predict IRA after examining the initial ECG changes such as R/S ratio, ST segment depression. This prediction can shorten the time required to perform primary percutaneous transluminal coronary angioplasty. Non-invasive prediction of IRA was useful for suggestion of clinical course in patients with high complication risk, such as patients with RCA lesion.
Cingözbay
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BY
Anittepe Jandarma Dispanseri, Ankara. gatadahiliye@superonline.com
Ozmen
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Top
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Cebeci
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Demiralp
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000503:physiopathology*; D004562:Electrocardiography / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011237:Predictive Value of Tests