Identification of culprit vessel from ECG

Identification of culprit vessel from ECG Identification of culprit vessel or infarct artery localization from ECG is useful during primary angioplasty. The initial diagnostic angiogram shot is taken in the artery which is not the culprit vessel, with a diagnostic catheter. Guide catheter is used for diagnostic shot in the suspected culprit vessel after that. This saves time during primary angioplasty. Have a look at the ECG below: Inferior wall infarction It shows show ST segment elevation in leads II, III and aVF of about 3mm. ST segment depression is seen in leads I, aVL and V1 to V5. Overall features are suggestive of hyperacute phase of inferior wall myocardial infarction with “reciprocal” ST segment depression in anterior leads. Here is the left coronary angiogram of that person: Left coronary angiogram Left coronary angiogram shows total occlusion of distal left circumflex coronary artery with absent dye filling in a short segment (black arrow). Multiple significant lesions are seen in left anterior descending coronary artery (blue arrows). Significant lesions are also seen in the obtuse marginal branch of the left circumflex coronary artery (yellow arrows). The culprit lesion which has caused the infarction in this case is possibly the left circumflex occlusion. Generally, the ST elevation is more in lead III in right coronary occlusion while it is more in lead II in left circumflex occlusion. In this case, we have almost equal ST elevation in leads II and III. Bu...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Angiography and Interventions Cardiology ECG / Electrophysiology ECG Library Source Type: blogs