ABSTRACT
The electrocardiogram [ECG] is simple and non-invasive and can be recorded at bed side, its role in the diagnosis of acute myocardial infarction [AMI] is well established. We are aiming through this study to assess the predictive value of ST segment elevation pattern in reperfused anterior myocardial infarction as an index of infarct size and left ventricular function [LVF]. The study was conducted on 40 patients who were admitted to the Coronary Care Unit of the National Heart Institute between October 2000 and may 2001 with the diagnosis of first time acute anterior wall myocardial infarction. All patients included in the study were submitted to: Full history taking and clinical examination, laboratory investigation including: Serum cardiac enzymes CPK, LDH on admission, at 6 hour intervals for the first day and then daily until discharge, standard resting 12 electrocardiogram A 12 lead ECG was recorded immediately before reperfusion. Evaluation and classified the shape of ST elevation in V3 into 3 types: Concave type: ST-T segment rise with downward convexity group I, 2] straight type: ST-T segment raised obliquely like an inclined plane group II and convex type: ST-T segment rise with upward convexity Left ventricular function was evaluated by echocardiography: The left ventricle was divided into segments wall motion score is assigned [or each segment. Left sided cardiac catheterization with coronary angiography was performed to all patients within 2 weeks after the onset of infarction coronary artery patency was determined by TIMI grade 2,3. The grade of collateral filling in the LAD was evaluated according to the criteria of Rentrop et al. [no 0, visible filling of any collateral channel; 1] filling only of side branches without visualization of the epicardial segment; 2] partial filling of the epicardial segment; 3] complete filling of the epicardial segment, a good collateral channel was defined as grade 2,3 and poor collateral channel as grade 0 or 1. There was no significant difference in the smoking between the 3 groups regarding smoking, hypertension, Diabetes Mellitus and dyslipidemia. The infarct related artery [IRA] was the left anterior descending in 4.0 patient [100 percent of cases]