title: Lead aVL on electrocardiogram: emerging as important lead in early diagnosis of myocardial infarction?
abstract: Although a diagnosis of acute myocardial infarction (AMI) that mandates emergency reperfusion therapy requires ST-segment elevation greater than 1 mm in at least 2 contiguous leads, some of the early electrocardiogram (ECG) changes of AMI can be subtle. Any ST-segment depression or T-wave inversion in lead aVL may be implicated in left anterior descending artery lesion or early reciprocal changes of inferior wall myocardial infarction, particularly when the clinical context suggests ischemia. Early recognition of reciprocal changes and serial ECG help initiate early appropriate intervention. Heightened awareness of ST segment and T-wave changes in lead aVL is of paramount importance to quickly identifying life-threatening condition.
authors.affiliation: Department of Emergency Medicine, NYMC, Metropolitan Hospital Center, New York, NY; Department of Emergency Medicine, Mount Sinai School of Medicine, Lutheran Medical Center, New York, NY; Department of Emergency Medicine St George's University School of Medicine, Lutheran Medical Center, New York, NY. Electronic address: getawh@yahoo.com.
authors.forename: Getaw Worku
authors.initials: GW
authors.lastname: Hassen
authors.affiliation: Department of Internal Medicine, Metropolitan Hospital Center, New York, NY.
authors.forename: Soheila
authors.initials: S
authors.lastname: Talebi
authors.affiliation: Department of Cardiology, Mount Sinai School of Medicine, Lutheran Medical Center, New York, NY.
authors.forename: George
authors.initials: G
authors.lastname: Fernaine
authors.affiliation: Department of Emergency Medicine, NYMC, Metropolitan Hospital Center, New York, NY.
authors.forename: Hossein
authors.initials: H
authors.lastname: Kalantari
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D042241:Early Diagnosis; D004562:Electrocardiography; D006329:Heart Conduction System / Q000002:abnormalities* / Q000503:physiopathology; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology