Thursday, November 21, 2013

Interesting ECG (8)


(Image from Nakamura K et al. Arch Intern Med 2012; 172(5):389)

Recently there was a patient with typical anginic chest pain with similar ECG changes. If this ECG is alarming to you (it should be!), can you name where is the most likely coronary lesion?

5 comments:

Darrenmagic said...

This ECG carries a major message which can easily go unnoticed.

ECG showed ST-elevation in lead aVR with ST-depression in inferolateral leads.

Lead aVR is often neglected in routine clinical practice but its significance is being more recognized in the recent years. Not only is aVR ST elevation a valuable indicator for predicting left main coronary artery or three-vessel lesion with good accuracy, its presence is an important adverse prognostic sign in AMI.

Further reading:

CK Wong et al. Eur Heart J 2010; 31:1845

Nough H et al. Rom J Intern Med 2012; 50(2):159

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