Clinical features of emergency electrocardiography in patients with acute myocardial infarction caused by left main trunk obstruction

Circulation Journal : Official Journal of the Japanese Circulation Society
Tomohisa HiranoSachirou Watanabe

Abstract

To diagnose left main trunk (LMT) infarction by 12-lead standard electrocardiogram (ECG) is an important emergency technique, but the features in LMT infarctions have not been clarified. The study enrolled 140 subjects who were divided into 4 groups according to the location of the culprit artery: 35 with LMT, 35 with left anterior descending artery (LAD), 35 with right coronary artery and 35 with left circumflex artery. Various parameters obtained from the ECGs were analyzed. Average QTc interval (0.51 +/- 0.06 s) in LMT group was markedly longer than that in the 3 other groups. Average QRS axis (-10 +/- 77 degrees) in LMT infarction showed a remarkable left deviation. ST-segment elevation in lead aVR occurred in 28 patients (80.0%) in the LMT group. The ECG features of the LMT group could be classified into 2 main groups: right bundle branch block (RBBB) with a marked left axis deviation (RBBB + LADEV type) and ST-segment elevation in leads V2-5, I and aVL without abnormal axis deviation (LAD type). Either ST-segment elevation in lead aVR and marked prolongation of both the QRS width and QTc interval with a prominent abnormal axis deviation or ST-segment elevation in the broad anterior precordial lead with a normal QRS axis s...Continue Reading

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Citations

Jun 19, 2013·The American Journal of Emergency Medicine·Murtaza Akhter, Melissa Lamberson
Jun 28, 2011·The American Journal of Emergency Medicine·Jacob R Hennings, Francis M Fesmire
Sep 16, 2008·Journal of Electrocardiology·Kjell C Nikus, Markku J Eskola
Sep 18, 2007·The American Journal of Emergency Medicine·Pawel RostoffKrzysztof Zmudka
Nov 12, 2013·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Zhan Zhong-QunWang Xian-Ming
May 26, 2009·The American Journal of Cardiology·Alim ErdemMehmet Birhan Yilmaz
Jun 10, 2015·BMJ Case Reports·Geraldine GilliotOlivier Hugli
Jun 12, 2018·Journal of Cardiovascular Medicine·Cinzia D'AngeloGiuseppe Di Pasquale
Sep 19, 2019·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Gien-Kuo LeeKshitij Soni

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