ECG Changes of Kurisu et al Associated with 30-Day Mortality in a Patient with Acute Myocardial Infarction Following Occlusion of the Left Main Coronary Artery (LMCA)
Kurisu et al identified changes in the electrocardiogram that were associated with 30 day mortality for a patient with an acute myocardial infarction (AMI) following occlusion of the left main coronary artery (LMCA). The authors are from Hiroshima City Hospital in Hiroshima, Japan.
Exclusions: history of previous AMI, left ventricular hypertrophy, left bundle branch block (LBBB) and occlusion of the right coronary artery >= 75%
Changes in the ECG associated with 30-day mortality following LMCA AMI:
(1) ST segment elevation >= 0.1 mV in aVR AND ST segment elevation >= 0.1 mm in aVL
(2) ST segment depression >= 0.1 mV in V5
(3) left anterior fascicular block (LAFB)
(4) right bundle branch block (RBBB)
where:
• ST segment elevation in aVR and aVL suggests transmural ischemia over a large area supplied by the left anterior descending (LAD) artery.
• ST segment depression in V5 is associated with LAD occlusion proximal to the first septal branch.
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