title: Electrocardiographic differentiation between occlusion of the first diagonal branch and occlusion of the left anterior descending coronary artery.
abstract: OBJECTIVE
  We sought to electrocardiographically distinguish ST-segment elevation (STE)-acute myocardial infarction (AMI) caused by occlusion of the first diagonal branch (D1) from STE-AMI caused by occlusion of the left anterior descending coronary artery (LAD).
  
  
  METHODS
  We examined 28 patients with STE-AMI caused by D1 occlusion (G-D) and 342 with STE-AMI caused by LAD occlusion (G-L).
  
  
  RESULTS
  G-D had a higher prevalence of STE > or = 0.5 mm in each of leads I and aVL and a lower prevalence of STE > or = 1 mm in each of leads V(1) through V(6) than G-L. The prevalence of STE > or = 0.5 mm in lead aVL without STE > or = 1 mm in lead V(1) was higher in G-D (82.1%) than in G-L (9.4%, P < .01).
  
  
  CONCLUSIONS
  ST-segment elevation > or = 0.5 mm in lead aVL without STE > or = 1 mm in lead V(1) may be useful to distinguish STE-AMI caused by occlusion of the D1 from STE-AMI caused by occlusion of the LAD.
authors.affiliation: Internal Medicine 2, Oita University, Yufu 879-5593, Japan.
authors.forename: Munenori
authors.initials: M
authors.lastname: Kotoku
authors.forename: Akira
authors.initials: A
authors.lastname: Tamura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shinozaki
authors.forename: Yusei
authors.initials: Y
authors.lastname: Abe
authors.forename: Toru
authors.initials: T
authors.lastname: Watanabe
authors.forename: Junichi
authors.initials: J
authors.lastname: Kadota
mesh_terms: D000368:Aged; D023921:Coronary Stenosis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity