CORRELATION OF SEVERITY OF ST SEGMENT ELEVATION IN ACUTE INFERIOR WALL MYOCARDIAL INFARCTION WITH THE PROXIMITY OF RIGHT CORONARY ARTERY DISEASE

Abstract

Background: A number of researchers have used different electrocardiographical criteria to predictthe culprit vessel in acute inferior wall myocardial infarction (MI) cases. Therefore, thedetermination of infarct related artery in AMI is extremely important with regard to prediction ofpotential complications, furthermore, predicting the probable site of occlusion within RCA isworthwhile because proximal occlusions are likely to cause greater myocardial damage and an earlyinvasive strategy may be planned in such cases. Our study aimed at evaluating the ECG criteria topredict the proximity of lesion in the right coronary artery (RCA) in acute inferior wall MI cases.The Objectives were to predict the presence of a proximal lesion in right coronary artery by severityof ST segment elevation in inferior ECG leads. This cross-sectional study carried out at thedepartment of cardiology and cardiac catheterization at Jinnah Hospital, Lahore from April 2008 toSeptember 2008. Methods: A total of 60 patients who suffered from inferior wall MI were includedin the study who underwent coronary angiography in the first week. The ECGs of these patients werethen compared with the angiographic findings to correlate the proximity of culprit lesion in RCAwith the degree of ST segment elevation in inferior limb leads. Results: Out of 60 patients, 29(48.4%) had the culprit lesion in proximal, 23 (38.5%) in mid and 8 (13.4%) in distal RCA. Patientswith proximal RCA disease showed a mean ST segment elevation of 12.55±1.38 mm, with mid RCAdisease 8.39±0.89 mm and with distal RCA disease 6.0±0.54 mm. Conclusion: This studydemonstrated that the severity of ST segment elevation was correlated with proximity of RCA lesionKeywords: Right coronary artery, ST elevation MI, Acute Myocardial infarction