Diagnostic, prognostic and predictive value of posterior chest leads in acute inferior myocardial infarction

ABSTRACT

The aim of this work was to study the diagnostic, prognostic and predictive value of posterior chest leads [PCL] V7- V9 in patients with acute inferior myocardial infarction [AIMI] and its correlation coronary angiography. 30 patients with AIMI were included in this study they were into 2 groups group A, 11 patients with AIMI and ST-segment elevation [STE] in PCL group B, 19 patients with AIMI without STE in PCL. Routine laboratory investigation, creatine phosphokinse [CPK], 15 leads ECG, echocardiographic examination and coronary angiongraphy. The prevalence of STE in PCL in-patients with AIMI was 36.7% [group A], were older, more hyperlipidemic, had higher incidence of R/S>1 in V1-V2, more STD in V1-V3, taller upright T wave, higher CPK level, lower EF, higher incidence of MR and more complication [heart failure, MR, arrhythmia and postinfarction angina] than group B [P <0.05] they had more wall motion abnormalities [WMA] mainly posterolateral and inferolateral [P<0.01]. Left circumflex coronary artery was the infarct related artery in virtually all patients in group A while right coronary artery was in 89.5% of patients in group B there was a higher incidence of multivessel disease proximal and diffuse lesions in group A the sensitivity and specificity of STE in PCL, R/S >1 in V1-V2 and STD in V1-V3 in relation to PWMA in diagnosis of posterior myocardial infarction was 100%, 82.6%, 71.4%, 100%. 100% and 78.3% respectively. We recommend routine recording of leads V7 to V9 in all patients with an AIMI and suggest that STE identifies a group of big infarction who at higher risk