Open AccessDifferentiation between left circumflex and right coronary artery occlusions: Studies on ST‐segment deviation during percutaneous transluminal coronary angioplasty
Author(s) -
Hiasa Y.,
Morimoto S.,
Wada T.,
Hamai K.,
Nakaya Y.,
Mori H.
Publication year - 1990
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960131107
Subject(s) - medicine , right coronary artery , cardiology , st segment , circumflex , myocardial infarction , electrocardiography , occlusion , angioplasty , st elevation , artery , coronary occlusion , percutaneous coronary intervention , coronary angiography
To distinguish between acute occlusion of the right coronary artery (RCA) and the left circumflex artery (LCx) by electrocardiography, we studied ST‐segment deviation during balloon inflation in percutaneous transluminal angioplasty. The composite electrocardiographic criteria based on ST‐segment deviations increased the diagnostic specificity: that is, the finding of inferior infarction (ST‐segment elevation in leads II, III, aVF) without lateral infarction (ST‐segment elevation in leads V 5, 6 ) was highly suggestive of RCA occlusion (sensitivity and specificity: 35 of 43 cases, 81.4%; and 33 of 36cases, 91.7%), whereas ST‐segment elevation in leads V 5,6 (LCx: 23 of 36 cases; 63.9%, RCA: 5 of 43 cases; 11.6%) or isolated ST‐segment depression in leads V 2‐4 (LCx: 9 of 36 cases; 25.0%, RCA: none of 43 cases) was highly suggestive of LCx occlusion. These results indicated that the composite electrocardiographic criteria were useful in predicting the artery involved in acute myocardial infarction, although any single criterion was not sensitive or specific enough to differentiate right from left circumflex coronary artery occlusion.