Comparative observation between electrocardiogram manifestations and coronary artery angiography in patients with acute anterior wall myocardial infarction

Objective To study the characteristics of angiography and electrocardiogram in acute anterior wall myocardial infarction,and give clinical clue for deducing the location of coronary artery lesions. Methods One hundred and forty-two patients with acute anterior wall myocardial infarction for the first time and confirmed to have single vessel coronary artery disease by angiography,were divided into 4 groups according to the electrocardiogram (ECG) changes at onset of infarction:(1) Group A was single acute anterior wall myocardial infarction (46 cases).(2)Group B was anterior wall myocardial infarction with inferior wall ST elevation (37 cases).(3) Group C was anterior wall myocardial infarction with inferior wall ST depression (31 cases).(4)Group D was extensive anterior wall myocardial infarction (28 cases). Results The infarction related lesion were mainly on middle left anterior descending (LAD) arteries in group A (82%,36/44),The infarction related lesion were mainly on proximal LAD in group C (80%,24/30) and group D (85%,23/27). In contrast,group B had two distinct subsets of patients with either right coronary artery(54%,20/37),or LAD (46%,17/37),P0.001. The occlusive lesion and collaterals were similar among the patients with anterior wall infarction or plus inferior wall ST change,were worse in the patients with extensive anterior infarction. Conclusion The location of infarction-related lesions can be deduced from the ECG change at the onset of anterior wall infarction,and infarction area can be limited by better collaterals.