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In patients with a posteroinferior acute myocardial infarction and both ST depression (in lead V1 or V2) and ST elevation in the inferior leads, it is difficult to differentiate a left circumflex artery occlusion from a right coronary artery occlusion. Furthermore, there is no useful method to identify the obstruction site in the left circumflex artery. In a study of 52 patients with single-vessel left circumflex artery disease, ST elevation in V6 was found to be a useful indicator for left circumflex artery occlusion in such patients. Furthermore, the sum of the ST changes in leads a VF and V2 is useful for identifying the occluded site in the left circumflex artery.

Electrocardiographic Diagnosis of Left Circumflex Artery Occlusion and the Occlusion Site.