title: ST elevation in ECG lead aVR signals severe acute left main coronary artery disease.
abstract: Patients with suspected acute coronary syndrome are commonly assessed by acute physicians on arrival in hospital. Although most will recognise the typical ECG features of ST elevation myocardial infarction, the significance of ST elevation in lead aVR may not always be appreciated. This case series describes 6 cases in which this ECG abnormality was the predominant feature in patients whose subsequent angiogram revealed severe acute left main coronary artery disease. The importance of early referral of such patients to a centre in which percutaneous coronary intervention can be performed, is discussed.
authors.forename: A
authors.initials: A
authors.lastname: Ghosh Dastidar
authors.forename: P
authors.initials: P
authors.lastname: Garg
authors.forename: J N
authors.initials: JN
authors.lastname: West
authors.forename: R
authors.initials: R
authors.lastname: Muthusamy
authors.affiliation: Dept Cardiovascular Science, University of Sheffield, Room M116, Medical School, University of Sheffield, Beech Hill, Road, Sheffield, S10 2RX.
authors.forename: J P
authors.initials: JP
authors.lastname: Gunn
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome