ECG Predictors of Engelen et al for the Site of Occlusion in the Left Anterior Descending (LAD) Artery in a Patient with an Anterior Acute Myocardial Infarction

 

Patient selection: acute anterior myocardial infarction (with ST segment elevation >= 2 mm in V2 and V3.

 

ECG changes associated with an occlusion proximal to S1 (first septal perforator):

(1) ST elevation in V1 >= 2.5 mm

(2) complete right bundle branch block (RBBB)

(3) ST segment elevation in aVR (usually small)

(4) ST segment depression in V5

 

ECG changes associated with an occlusion proximal to D1 (first diagonal branch):

(1) Q wave in aVL

 

ECG changes associated with an occlusion proximal to S1 and D1:

(1) ST segment depression in inferior leads (II, III, aVF) >= 1 mm

 

ECG changes associated with an occlusion distal to S1:

(1) Q wave in V4, V5, V6

 

ECG changes associated with an occlusion distal to D1:

(1) ST segment depression in aVL

 

ECG changes associated with an occlusion distal to S1 and D1:

(1) absence of ST segment depression in inferior leads (II, III, aVF)