title: Correlation of severity of ST segment elevation with respect to the site of right coronary artery lesion.
abstract: BACKGROUND
  Electrocardiogram a widely available tool may predict infarct related artery in acute inferior wall myocardial infarction. Severity of ST segment elevation may correlate with proximity of lesion in right coronary artery.
  
  
  METHODS
  Patient with acute ST segment elevation inferior wall myocardial infarction who underwent coronary angiogram was studied. Differences in electrocardiogram among right coronary and left circumflex groups were evaluated. Severity of ST segments elevation in relation to site of lesion in right coronary was studied.
  
  
  RESULTS
  The mean age of presentation was 59.52 ± 11.01 years. Total 36 (72%) were men. A total of 42 (84%) had lesion in right and 8 (16%) in left circumflex. Age, sex,diabetes,hypertension, smoking, dyslipidemia and physical activity showed no correlation with lesion in right or circumflex coronary artery. ST segment elevation in III>II (P=0.01), ST segment depression in AVL> I (P<0.01) and ST elevation in V4R (P=0.04), correlated with right coronary lesion. Sum of ST elevation in inferior leads were 10.90 ±1.30 mm for proximal, 7.38±1.19 mm for mid and 5.50± 0.53 mm for distal right coronary with significant correlation (P<0.01).
  
  
  CONCLUSIONS
  Electrocardiogram was reliable tool to difference right and left circumflex lesion. Severity of sum of ST segment elevations in inferior leads correlated with the proximity of lesion in right coronary.
authors.affiliation: Department of Cardiology, National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal.
authors.forename: Rabindra
authors.initials: R
authors.lastname: Simkhada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology*; D003331:Coronary Vessels; D004562:Electrocardiography; D005260:Female; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index