title: Features of electrocardiogram in patients with stenosis of the proximal right coronary artery.
abstract: OBJECTIVE
  Prediction of lesions of the proximal right coronary artery (pRCA) through electrocardiogram (ECG) is very important because pRCA occlusion has many complications and a high mortality rate, which has frequently been related with right ventricular infarction. The purpose of this study was to devise a screening tool that takes into account multiple leads from a 12-lead ECG to predict the pRCA lesion.
  
  
  METHODS
  A hundred and fifty-eight patients who were diagnosed as acute coronary syndrome and had a pure lesion of RCA or left circumf lex artery (LCX) by ECGs and angiographic findings were enrolled retrospectively. Forty-eight patients with a pure pRCA occlusion were compared to a control group of 110 patients who were diagnosed as having either a pure mid to distal RCA lesion (57 patients) or a pure LCX lesion (53 patients).
  
  
  RESULTS
  ECGs of patients in the pRCA group showed more prominent ST depression in lead I (p= 0.001) and ST elevation in V1 (p= 0.002) than in the control group. The combination of ST depression (≤ 0 mm) in I and ST elevation (> 0.5 mm) in V1 was the best diagnostic tool (area under the curve, 0.84).
  
  
  CONCLUSIONS
  ST changes in leads V1 and I allow more accurate prediction of pRCA occlusion than other criteria, such as the difference between ST elevation of leads II and III or vector direction and amplitude. These variables could help to screen for right ventricular infarction before performing reverse ECG and predicting prognosis.
authors.affiliation: Department of Emergency Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Moo Seong
authors.initials: MS
authors.lastname: Koh
authors.affiliation: Department of Emergency Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Jeong
authors.affiliation: Department of Emergency Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Chung
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies
keywords: Coronary angiography; Coronary artery disease; Electrocardiography; Myocardial infarction