scholarly journals Case Report: Acute Inferior Myocardial Infarction with Single-Lead ST Segment Elevation

2002 ◽  
Vol 9 (3) ◽  
pp. 154-158
Author(s):  
YS Sia ◽  
YT Wong
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Early Recognition ◽  
Morbidity And Mortality ◽  
Inferior Myocardial Infarction ◽  
St Segment Elevation ◽  
St Segment ◽  
Acute Inferior Myocardial Infarction

This article illustrates a patient who presented with acute inferior myocardial infarction with only isolated ST segment elevation in Lead III. Brief review on the electrocardiographic interpretation was discussed. Early recognition and management is the key to prevent morbidity and mortality.

scholarly journals Incidence of 'Precordial ST-Segment Depression' in Acute Inferior Myocardial Infarction

1970 ◽  
Vol 6 (1) ◽  
pp. 21-22
Author(s):  
Md Mobashir Khalil ◽  
AKM Fazlur Rahman ◽  
Chowdhury Meshkat Ahmed ◽  
Shah Md Iqbal ◽  
KMHS Sirajul Haque
Keyword(s):  
Myocardial Infarction ◽  
Age Group ◽  
Inferior Myocardial Infarction ◽  
Younger Patients ◽  
St Segment Elevation ◽  
St Segment ◽  
Number Of Patients ◽  
Group 2 ◽  
Acute Inferior Myocardial Infarction ◽  
Group 1

Patients of acute inferior myocardial infarction, in addition to the ST segment elevation in inferior leads often have ST segment depression in the precordial leads. This study was performed to observe the incidence of these ‘reciprocal’ ST changes. One hundred consecutive acute inferior myocardial infarction patients were included in the study. They were further allocated to two electrocardiographic groups. Group 1 consisted of patients of acute inferior myocardial infarction with precordial ST segment depression & Group 2 consisted of patients of acute inferior myocardial infarction without precordial ST segment depression. Among the 100 consecutive patients, a large number of patients were included in group 1 (76%). Significant number of patients of group 1 belonged to the age group of above 60 years compared to group 2 (27.6% vs. 4.2%; p < .02). Conversely significantly higher number of younger patients ≤ 40 years belonged to group 2 (41.7% vs. 11.9%; p < .01). Mean ST segment elevation (mm) was also significantly higher in group 1 than group 2 (4.07 ± 1.93 vs. 2 ± 0.78; p <.001). The patients of acute inferior myocardial infarction thus show a significant number of ST segment depression in their precordial leads. In different studies these subset of patients showed increased morbidity and mortality. Key words: acute inferior myocardial infarction; precordial ST segment depression. DOI: 10.3329/uhj.v6i1.7185University Heart Journal Vol.6(1) 2010 pp.21-22

scholarly journals Comparison of ST segment Changes in Lead aVR with in-Hospital Outcomes in Patients with First attack of Acute Inferior ST Segment Elevation Myocardial Infarction

2019 ◽  
Vol 11 (2) ◽  
pp. 123-128
Author(s):  
Mohammad Jalal Uddin ◽  
M Saiful Bari ◽  
MA Bari ◽  
Mirza Md Nazrul Islam ◽  
M Abdullah Al Safi Majumder ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Inferior Myocardial Infarction ◽  
Hospital Outcomes ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Group A ◽  
Lead Avr ◽  
Group B ◽  
Acute Inferior Myocardial Infarction

Background: Inferior wall ST segment elevation myocardial infarction is considered to be at lower risk than anterior wall STEMI except in some cases. The aim of our study was to evaluate the relationships between on admission ST segment changes in lead aVR and short term in-hospital outcomes in acute isolated inferior myocardial infarction undergoing thrombolysis. Methods: Total 107 of first attack of inferior STEMI patients were included and all were thrombolysed by streptokinase. The sample population were divided into three groups based on the condition of ST segment in lead aVR on admission and in hospital outcomes were observed: Group –A: ST segment elevation ≥0.5 mm; Group –B: ST segment depression ≥0.5 mm; Group-C: Iso-electric ST segment. Results: 6.54% of study population had ST segment elevation in lead aVR, 53.27% had ST segment depression in lead aVR and 41.12% had isoelectric ST segment in lead aVR. During hospital stay mortality rates of patients of Group A, Group B and Group C were 33.3%, 5.3% and 4.5 % respectively; rates of cardiogenic shock were 33.3%, 8.8% and 2.3% respectively; heart failure rates were 50.0%, 15.8% and 4.5% respectively; rates of recurrent angina after thrombolysis were 66.7%, 33.3% and 6.8% respectively in three groups and the mean LVEF were 40.17, 48.61 and 52.50 respectively. Conclusion: The on admission-isoelectric ST segment in lead aVR in acute inferior myocardial infarction predicted better in-hospital outcomes in comparison to ST segment elevation and ST segment depression in aVR. On the other hand, ST segment elevation in lead aVR predicted worse in-hospital outcomes than ST segment depression in acute inferior myocardial infarction in spite of reperfusion by thrombolytic. Cardiovasc. j. 2019; 11(2): 123-128

scholarly journals Correlation of ECG Changes with Coronary Angiographic Findings in Acute Inferior Myocardial Infarction

2017 ◽  
Vol 29 (2) ◽  
pp. 33-37 ◽  
Author(s):  
Kazi Shamim Al Mamun ◽  
Anisul Awal ◽  
AKM Manzur Murshed
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Inferior Myocardial Infarction ◽  
Significant Stenosis ◽  
St Segment Elevation ◽  
St Segment ◽  
Infarct Related Artery ◽  
St Elevation ◽  
Acute Inferior Myocardial Infarction

The determination of infarct related artery in acute inferior myocardial infarction is extremely important for the prediction the amount of myocardium at risk and guide decisions regarding urgency of revascularization. Urgent decision may facilitate management and prevention of complication. Our objective was to Identification of the infarct related artery involving either right coronary artery (RCA) or left circumflex artery (LCX) in acute inferior wall myocardial infarction using electrocardiographic criteria and comparing with angiographic finding. This prospective, observational study was done in Chittagong Medical College Hospital from June 2013 to May 2014. A total of 112 Patients with acute inferior myocardial infarction were included in this study. The electrocardiogram of these patients evaluated for ST segment elevation in lead III exceeding that in lead II (i.e. a ratio of ST elevation in lead III/elevation in lead II > 1) and S/R wave ratio > 0.33 plus ST segment depression > 1 mm in lead aVL as a prediction for right coronary artery occlusion. If criteria are negative, LCX obstruction is likely. Coronary angiogram was done within 2-6 weeks in cath lab, department of cardiology, CMCH to identify the culprit artery. The infarct related artery (IRA) was identified from total occlusion or significant stenosis (> 70%) of the RCA or LCX or their major branches, or from arteriographic evidence of intraluminal thrombosis. To minimize the chance of misclassifying the culprit artery, patients with significant stenosis of both the RCA and the LCX were excluded from the study. The study population consisted of 112 patients (94 male and 18 female) with a mean ± SD age of 51 ± 8.6 years. On coronary angiography, the culprit artery was shown to be the RCA in 92 patients and the LCX in 20 patients. It was evident that the degree of ST segment elevation in lead III was significantly higher in right coronary artery group (92 patients) vs left circumflex group (20 patients) 3.16±1.14mm vs 1.35±0.24mm (p<0.001) respectively. While its comparable in lead II 2.18±0.95mm vs 1.7±0.34mm (p>0.05). In respect to leads AVL, we found that deeper ST segment depression was in right coronary artery group as compared to left circumflex group 1.11±0.25mm vs 0.2 ±0.34mm (p<0.001). ECG parameters for implicating the RCA were a higher ST elevation in lead III than lead II (specificity 98%, sensitivity 97%) and an S/R wave ratio > 0.33 plus ST segment depression > 1 mm in lead aVL (specificity 96%, sensitivity 95%). Absence of these criteria was associated with LCX occlusion (specificity 100%, sensitivity 85%). It is possible to predict the culprit artery whether right coronary artery or left circumflex by examining the surface electrocardiography in patients with acute inferior myocardial infarction.Medicine Today 2017 Vol.29(2): 33-37

scholarly journals In-Hosptal Outcome and Angiographic Findings in Acute Inferior Myocardial Infarction with ST-Segment Elevation in Posterior Chest Leads ( V7, V8, V9 ) Following Thrombolytic Therapy

2017 ◽  
Vol 31 (2) ◽  
pp. 58-64
Author(s):  
Mohamed Haneef ◽  
Abdullah Al Shafi Majumder ◽  
M Atahar Ali ◽  
Md Shafiqur Rahman Patwary ◽  
Md Arifur Rahman
Keyword(s):  
Myocardial Infarction ◽  
Adverse Outcome ◽  
Posterior Wall ◽  
Inferior Myocardial Infarction ◽  
St Segment Elevation ◽  
Group I ◽  
St Segment ◽  
Group Ii ◽  
Vessel Score ◽  
Acute Inferior Myocardial Infarction

Background: Electrocardiographic diagnosis of a posterior wall myocardial infarction is difficult to accomplish by the standard 12-lead ECG. Early detection of posterior wall involvement in an inferior myocardial infarction is of paramount importance for the therapeutic outcome. The aim of this study is to assess the role of ST segment elevation in posterior wall leads (V7, V8, V9) on the admission ECG of acute inferior myocardial infarction, for the diagnosis of posterior wall myocardial infarction and the identification of infarct related artery as well as in-hospital outcome following thrombolysis.Methods: A total of 90 patients with acute inferior MI were enrolled by purposive sampling. On the basis of ST segment elevation in posterior leads (V7,V8,V9), study subjects were categorized into two groups: 45 patients of acute inferior MI with ST segment elevation in posterior leads as group I and 45 patients of acute inferior MI without ST segment elevation in posterior leads as group II. Coronary angiography was done during index hospital admission. Interpretation of coronary angiogram was done by visual estimation by two cardiologists to assess the severity of coronary artery disease. Severity of coronary stenosis was graded according to the number of major epicardial vessel with significant stenosis by vessel score and Friesinger score. After CAG, patients were evaluated for in hospital adverse outcome like heart block, cardiogenic shock, arrhythmia, and death.Results: Patients of PMI and non PMI groups were similar in terms of age and sex. Smoking and dyslipidemia (p=0.05) were significantly higher in PMI group. Mean RBS and Troponin-I difference were significantly (p<0.05) higher in group I. Majority of patients had ejection fraction 45-55% in both groups. Patients in group I showed more normal LVEF, than group II, which was statistically significant. This study provided the evidence that the ST segment elevation in posterior leads associated with more left circumflex (LCX) and posterior left ventricular brass (PLVB) involvement. Majority of the patients had vessel score 2, Friesinger score 5-10 in group I and vessel score 1, Friesinger score 1-4 in group II.Conclusion: ST segment elevation in posterior chest leads (V7, V8, V9) were associated with more in-hospital adverse outcome than those who had inferior MI alone. This group of patients had more PLVB involvement. Recording of posterior precordial leads appear to be beneficial for risk stratification and to locate the site of lesion in patients admitted with acute inferior myocardial infarction. Since it is inexpensive method, it may be used in any hospital.Bangladesh Heart Journal 2016; 31(2) : 58-64

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