| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 6
| Issue : 4 | Page : 128-132 |
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Role of electrocardiogram in identification of culprit vessel occlusion in acute ST elevation myocardial infarction in relation to coronary angiography
Kunal K Salunke MBBS, M.D. Medicine; , Rajesh J Khyalappa MBBS, M.D. Medicine
Department of Medicine, Dr. D.Y. Patil Medical College, D.Y. Patil University, Kolhapur, Maharashtra, India
Correspondence Address:
Rajesh J Khyalappa
Department of Medicine, Dr. D.Y. Patil Medical College, D.Y. Patil University, Kolhapur, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/JCPC.JCPC_11_17
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Objective: The objective of the study is to study the usefulness of electrocardiography in localizing the culprit vessel in acute ST-elevation myocardial infarction (STEMI) and to assess the diagnostic accuracy of the electrocardiogram (ECG) findings by comparing them with coronary angiographic findings. Materials and Methods: This study is prospective observational study, conducted on fifty patients in tertiary care center attached to medical college. Patients with ST-segment elevation in ECG was evaluated to identify culprit vessel and later correlated with their coronary angiography. Results: Among fifty patients in the study, 34 had anterior wall, and 16 had inferior wall myocardial infarction. ST↑ >1 mm in V4R, ST↓V3/ST↑LIII <0.5 were equally sensitive for diagnosing proximal right coronary artery occlusion. For left circumflex occlusion, ST elevation in lead III >lead II was the most sensitive and ratio of ST↓V3/ST↑LIII >1.2 was the most specific criterion. In anterior wall STEMI, 52.9% patients had occlusion proximal to first septal (S1), 17.6% had occlusion proximal to first diagonal (D1), 8.8% had occlusion distal to S1, and 20.5% had occlusion distal to D1. Q wave in aVL had maximum sensitivity for identifying occlusion proximal to D1 and Q wave in leads V4-V6 for occlusion distal to S1. Conclusion: The admission ECG in patients with STEMI is valuable not only for determining early reperfusion treatment, but also provides important information to guide clinical decision-making. |
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