Electro-cardiographic detection of the site of totally occluded left anterior descending coronary artery

ABSTRACT

The goal of this study was to undertake the assessment of the value of ST-segment changes in various ECG leads during evolving acute anterior wall myocardial infarction in predicting the location of left anterior descending coronary artery obstruction by coronary angiography. A total number of 40 patients were enrolled between October 2000 and June 2001. All patients subjected to full history taken, clinical assessment, twelve leads resting ECG serial cardiac enzymes, laboratory tests, echocardiography and coronary angiography. According to angiographic results, patients were classified into Group A having proximal LAD and group B having mid and/or distal LAD lesion. In this study, the presence of the ST-segment elevation in lead land aVL were greater and more frequent when lesion was in the proximal LAD than when it was in the mid or distal segment. On the other hand, the presence of ST-segment depression in leads II, III and aVF also were greater and more frequent when the lesion was in the proximal LAD than it was in the mid or distal segment. Also, this work demonstrated that STsegment depression in inferior leads II, III and aVF was strongly correlated with ST-segment elevation in leads I and aVL. Also, group A had a significantly higher incidence family history of ischaemic heart disease than group B. This work concluded that patients with proximal LAD lesion had a worsen prognosis than patients with mid or distal LAD lesion