Clinical Significance of ST Segment Elevation in Posterior Leads V7, V8 and V9 in Patients with Acute Inferior Wall Myocardial Infarction
|Dipesh Pradhan1*, Sun Jian1, Rajina Shrestha2, Madhu Gupta1, Sanaya Karki3 and Liu Xiao Fei1|
|1Department of Internal Medicine (Cardiology), Norman Bethune of College of Medicine, The First Hospital of Jilin University, Changchun 130021, China|
|2Department of Obstetrics and Gynecology, Jiamusi University, China|
|3Department of Emergency Medicine, Norman Bethune of College of Medicine, Jilin University, Changchun 130021, China|
|4Department of Cardiology, Norvic International Hospital, Kathmandu, Nepal|
|Corresponding Author :||Sun Jian MD
Department of Cardiology
Norman Bethune College of Medicine,
The First Bethune Hospital of Jilin University
Changchun 130021, PR China,
E-mail: [email protected]
|Received March 23, 2013; Accepted April 16, 2013; Published April 23, 2013|
|Citation: Pradhan D, Jian S, Shrestha R, Gupta M, Karki S, et al. (2013) Clinical Significance of ST Segment Elevation in Posterior Leads V7, V8 and V9 in Patients with Acute Inferior Wall Myocardial Infarction. J Cardiovasc Dis Diagn 1:106. doi: 10.4172/2329-9517.1000106|
|Copyright: © 2013 Pradhan D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objectives: The aim of the study was to assess the role of ST segment elevation in the Posterior leads V7,
V8, and V9 for the diagnosis of acute posterior wall infarction and the identification of infarct related artery (IRA) in patients with acute inferior wall MI.
Background: The posterior wall infarction is difficult to diagnose through standard 12 lead ECG alone, especially in the acute setting.
Methods: In our retrospective study, 121 patients (101 male, 20 female) with an inferior acute MI, were included. They were divided into two groups according to the presence (Group A: mean age 60.00±10.05 years) or absence (Group B: mean age 57.65 ± 12.86 years) of ST segment elevation in leads V7, V8, V9. Complete demographic data were recorded in all subjects, the infarct size was estimated by CPK MB, left ventricular function was assessed by echocardiographically and infarct related artery patency was evaluated by coronary angiography.
Results: Group A patients had a higher frequency of Left cirucumflex occlusion than group B patients (n=33,
27.3% vs. n=4, 3.3%, p=0.0001). Group A had a more extensive infarction, as is shown by CPK MB values (90.12 ± 33.42 vs 45 ± 38.28, P= 0.0001) but with no difference in left ventricular ejection fraction.
Conclusion: ST segment elevation in posterior leads helps to diagnose left circumflex artery as a culprit IRA in an acute inferior wall MI with extensive infarct area involving posterolateral walls.