Correlation of ST Segment Elevation in Lead V1 and the Conal Branch of Right Coronary Artery in Patients with Acute Anterior Wall Myocardial Infarction.
10.4070/kcj.2003.33.10.871
- Author:
Ho Shik SHIN
1
;
Su Hong KIM
;
Eun Seok KIM
;
Jin Wuk HUR
;
Byung Joo CHOI
;
Seong Man KIM
;
Tae Joon CHA
;
Seung Jae JOO
;
Jae Woo LEE
Author Information
1. Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea. sejjoo@ns.kosinmed.or.kr
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
Coronary vessels;
Electrocardiography;
Prognosis
- MeSH:
Anterior Wall Myocardial Infarction*;
Arteries;
Coronary Vessels*;
Electrocardiography;
Heart Failure;
Humans;
Incidence;
Myocardial Infarction;
Prognosis
- From:Korean Circulation Journal
2003;33(10):871-877
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Dual blood supply to the anterior interventricular septum (IVS), derived from the septal branches of the left anterior descending artery (LAD) and the conal branch of the right coronary artery (RCA), may prevent ST segment elevation in lead V1 during an anterior acute myocardial infarction (AMI), and predict a favorable in-hospital clinical course. SUBJECTS AND METHODS: The admission 12-lead electrocardiogram (ECG), and the coronary angiograms performed within 10 days of hospital admission, were evaluated in 67 patients with anterior wall AMI, as defined by a ST segment elevation > or =2mm in at least 2 of the V1 to 4 leads. The patients were divided into two groups according to the magnitude of the ST segment elevation in V1 lead: group 1 (ST <1.5 mm, n=22) and group 2 (ST > or =1.5 mm, n=45). The conal branch types were classified into small (a diameter <0.5 mm), not reaching the IVS, and large (a diameter >0.5 mm), reaching the IVS. RESULTS: A large conal branch was found in 11 patients of each group 50 and 24%, respectively (p=0.04). There was no significant relation between the sites of the LAD lesion, whether proximal or distal to the first septal branch, and the presence of ST segment elevation in lead V1. The serum cardiac enzymes, Killip class and the incidence of in-hospital congestive heart failure, were not significantly different. CONCLUSION: The absence of ST segment elevation in lead V1 during an anterior AMI suggested that the IVS is protected by a large conal branch, in addition to the septal branch of the LAD, but this did not influence the in-hospital clinical course.
