A Simple Electrocardiographic Reading for Identifying the Culprit Site of Coronary Artery Occlusion in Inferior Wall Acute Myocardial Infarction
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 19, Issue 2
Abstract
Background and Methods: The culprit site of coronary artery occlusion is a major determinant of prognosis in patients with inferior wall acute myocardial infarction (AMI). A two-step strategy was performed to evaluate whether one simple electrocardiographic (ECG) reading can be used to identify the three possible sites of coronary artery occlusion in patients with inferior wall AMI. An initial retrospective study analyzed which ECG criterion was the most appropriate criterion in determining the culprit sites of coronary artery occlusion in 107 patients with inferior wall AMI. Subsequently, a prospective study investigating the usefulness of this criterion in identifying the high risk or proximal right coronary artery (RCA) occlusion patients was assessed in another 110 patients with inferior wall AMI. Results: The retrospective investigation found that the ratio of ST segment elevation in lead III to lead II (III/II ratio) was the most powerful criterion in discriminating the three culprit sites. The III/II ratio > 1.8 predicted proximal RCA occlusion, III/II ratio between 1.2 and 1.8 predicted distal RCA occlusion, and III/II ratio < 1.2 predicted left circumflex artery occlusion. The second validation study showed that the sensitivity, specificity, and accuracy of identifying the proximal RCA occlusion using III/II ratio > 1.8 was 61%, 86%, and 76%, respectively. Conclusion: This study demonstrates that a simple ECG criterion (III/II ratio) can be used to identify the 3 culprit sites and the III/II ratio > 1.8 was capable of identifying the high-risk patients in inferior wall AMI.
Authors and Affiliations
Li Ping Chou, Wei Chun Huang, Chieh Kao, Yen Hsun Chen, Hung Fu Tseng, Shoa Lin Lin
Keywords
Related Articles
- EP ID EP620674
- DOI 10.26717/BJSTR.2019.19.003269
- Views 126
- Downloads 0
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