The Prognostic Significance of Maximal Precordial ST-Segment Depression in Patients with Acute Inferior Myocardial Infarction.
10.4070/kcj.1996.26.4.781
- Author:
Hyae Young LEW
;
Yong Sun YUN
;
Heung Sun KANG
;
Chung Whee CHOUE
;
Kwon Sam KIM
;
Myung Shick KIM
;
Jung Sang SONG
;
Jong Wha BAE
- Publication Type:Original Article
- Keywords:
Acute inferior myocardial infarction;
Reciprocal ST-segment depression;
Prognostic significance
- MeSH:
Coronary Vessels;
Depression*;
Electrocardiography;
Heart Block;
Heart Failure;
Humans;
Incidence;
Infarction;
Inferior Wall Myocardial Infarction*;
Mortality;
Myocardial Infarction;
Prognosis
- From:Korean Circulation Journal
1996;26(4):781-786
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Inferior myocardial infarctions account for 40-50% of all acute myocardial infarctions and are generally viewed as having a more favorable prognosis than anterior wall infarctions. However, nearly 50% of patients suffering inferior infarction will have complications such as heart block, concomitant precordial ST-segment depression and right ventricular infarction or distinguishing features associated with an increased mortality that will substantially alter an otherwise favorable prognosis. METHODS: Clinical characteristics, electrocardiograms, and angiographic findings of coronary artery were viewed in 47 patients with inferior myocardial infarction. Significant ST-segment change was defined as > or =0.1mV horizontal or down sloping depression in acute inferior myocardial infarction patients with ST-segment elevation on leads II, III, aVF measured with reference to the TP segment, 80ms after J point. A group=no precordial ST-segment depression. B group=sum of ST-segment depression in leads V1 to V3 equal to or more than the sum of ST-segment depression in leads V4 to V6. C group=maximal precordial ST-segment depression in leads V4 to V6. RESULTS: 1) Incidence of multi-vessel disease in group A and in group B were 23% and 22%, respectively, compared with 60% for those of group C(p<0.05). 2) Incidence of Killip class III and IV rates in patients with group A and B were 8% and 12%, respectivly, compared with 47% for those patients with group C(p<0.05). 3) No significant difference of sex, age, peak CK level were found among three groups(p>0.05). CONCLUSION: The patients with acute inferior myocardial infarction with the maximal ST-segment depression in leads V4 to V6 would be at high risk for congestive heart failure and multi-vessel disease.
