Kurisu et al identified changes in the electrocardiogram associated with mortality following an acute myocardial infarction (AMI) involving the left main coronary artery. These can help to identify a patient who may benefit from more aggressive management. The authors are from Hiroshima City Hospital in Hiroshima, Japan.


Patient selection: AMI associated with occlusion of the left main coronary artery


Outcome: death within 30 days of the AMI


ECG findings associated with death within 30 days of the AMI:

(1) right bundle branch block

(2) left anterior fascicular block

(3) ST segment elevation >= 0.1 mV in both aVR and aVL


Survivors were more likely to have ST segment depression >= 0.1 mV in V5.


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