Correlation between electrocardiogram (ECG) and coronary finding in patients with acute ST elevation myocardial infarction

Sanoussi Hamza; Hasni Mohammed Ali; Kourireche Najla; Lakhal Zouhair

Volume : VII, Issue : XII, December - 2018

Correlation between electrocardiogram (ECG) and coronary finding in patients with acute ST elevation myocardial infarction

Sanoussi Hamza, Hasni Mohammed Ali, Kourireche Najla, Lakhal Zouhair

Abstract :

ObjetiveS: The aim of this work is to expose the important role of the ECG in identifying the culprit artery in STEMI.

METHODS:

Retrospective study of 100 patients admitted to the military hospital, Rabat, Morocco, with the diagnosis of myocardial infarction (within 24 hours of symptoms onset) from January 2013 to December 2014. We differentiate anterior and inferior MI. In inferior MI patients were enrolled in two groups depending on culprit artery: Right Coronary Artery (RCA group, N:24) and Left Circumflex artery (LCx group, N: 17).

RESULTS:

The mean age was 60.3 ± 9.2 years with extremes ranging from 31 years to 83 years, and 91% were male. 41% of patients had at least two cardiovascular risk factors. Smoking was the predominant cardiovascular risk factors and diabetes affected half of patients.

Almost 60% of patients were admitted < 6 hours following the onset of pain.

The localization of MI was anterior in 55%. LAD was the culprit lesion in 98% of cases. The sum of ST segment elevation was found in leads V1, V2, V3 and V4. The antero–septal localization was related to mid–LAD lesion in 67% of cases, and the extended anterior myocardial infarction was related to proximal LAD lesion in 73% of cases. In inferior MI, ST segment elevation was more marked in lead DIII than DII in 88% of the RCA group versus 6% only in LCx group. The ST segment depression was more important in lead aVL than DI in 91% of the RCA group against 6% only in the LCx group. Both criteria were positive in 83% of patients in the RCA group and 0% in the LCx group, while both criteria were negative in 88% of the LCx group and 0% in the RCA group (p<0.001).

CONCLUSIONS:

In anterior MI, LAD is almost always the culprit artery, ECG analysis can help to identify the segment involved: proximal, mid or distal. In inferior MI, ECG studies can allow to identify the culprit lesion with much more precision