Left main coronary artery disease on ECG

Left main coronary artery disease on ECG Left main coronary artery disease on ECG ST segment elevation in aVR and diffuse ST segment depression in inferior and anterolateral leads is considered a feature of significant left main coronary artery disease. The ECG shown above, there is ST segment elevation in aVR and V1 along with ST depression in inferior and lateral leads. ST elevation in aVR more than that in V1 is also suggestive of left main disease. In a study comparing acute obstruction of left main, left anterior descending (LAD) and right coronary (RCA) occlusions, aVR ST elevation of more than 0.05 mV was noted in 88% of left main (LMCA) obstruction, 43% of LAD obstruction and 8% of RCA obstruction [1]. One limitation of the study was lack of comparison with left circumflex (LCX) obstruction. In addition to ST elevation in aVR, this ECG also shows Q in V1 followed by a tall slurred R (QRBBB) is indicative of anterior wall infarction with right bundle branch block. The initial R of the RSR’ pattern expected in right bundle branch block (RBBB) is knocked off by the infarction. Multiple supraventricular ectopics are also seen in the ECG. In a case reported by Shinde RS et al, coronary angiography documented total occlusion of left coronary artery and the patient underwent emergency coronary artery bypass surgery (CABG) [2]. In that case there was ST depression in I, aVL, II, aVF and V2-V6. ST elevation was 2 mm in aVR and 1 mm in V1. This patient had reported with ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: ECG / Electrophysiology ECG Library Source Type: blogs