Open AccessAcute anterior wall myocardial infarction entailing st‐segment elevation in lead v 1 : Electrocardiographic and angiographic correlations
Author(s) -
Bengal Tuvia,
Herz Itzhak,
Solodky Alejandro,
Birnbaum Yochai,
Sclarovsky Samuel,
Sagie Alex
Publication year - 1998
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.4960210606
Subject(s) - medicine , cardiology , culprit , st segment , myocardial infarction , right coronary artery , st elevation , artery , lead (geology) , interventricular septum , electrocardiography , vectorcardiography , coronary angiography , geomorphology , ventricle , geology
Background : The correlation between ST elevation in lead V 1 during anterior wall acute myocardial infaction (AMI) and the culprit lesion site in the left anterior descending (LAD) coronary artery is poor. Hypothesis : The study was undertaken to assess the electrocardiographic (ECG) characteristics and angiographic significance of ST‐segment elevation in lead V 1 during anterior wall acute myocardial infarction (AMI). Methods : Data from 115 patients with anterior wall AMI, who underwent coronary angiography within 14 days of hospitalization, were studied. The admission 12‐lead ECG was examined and the coronary angiogram was evaluated for the nature of the conal branch of the right coronary artery (RCA) and for the culprit lesion site in the left anterior descending (LAD) coronary artery. Results : Mean ST‐segment deviation and the frequency of patients with ST‐segment elevation > 0.1 mV were significantly lower in lead V i than in lead V2 (0.136 $$ 0.111 mV vs. 0.421 $$ 0.260 mV, and 37 vs. 96%, for leads Vi and Vi, respectively). A small conal branch not reaching the interventricular septum (IVS) was more prevalent among patients with ST‐segnicni elevation >0.1 mV in lead Vi (67%), whereas a large conal branch was more prevalent in patients with ST‐segment deviation (1 mV in that lead (83%, p<0.001). No relation was found between ST‐segment deviation in lead V i during anterior wall AMI and the culprit lesion site in the LAD. Conclusion : ST‐segment elevation in lead V 1 during first anterior wall AMI was found in one third of the patients, and its magnitude was lower than that in the other precordial leads. ST‐segment elevation in lead V 1 favors the presence of a small conal branch of the RCA that does not reach the IVS.