The value of body-surface electrocardiogram in the prediction of the related artery of inferior wall acute myocardial infarction

Objective: To investigate the value of body-surface electrocardiogram in the prediction of acute inferior myocardial infarction( AIMI) caused by left circumflex artery( LCX) or right coronary artery( RCA). Methods: The data of AIMI with ST segment elevation,coronary arteriography of LCX and IRA and the no-opening ECG were analyzed. The coronary artery lesion were determined by observing the ECGⅠ,aVL lead,aVR lead,V1,V5and V6lead and the baseline of ST segment( up or down) combined with analysing the coronary angiography and clinical data. Results: During 59 AIMI cases with ST segment elevation caused by LCX or RCA lesion, 7 cases with LCX occlusion and 52 cases with RCA occlusion were found. The occurrence rates of STⅠ,aVL down ST aVR up and down to less than 0. 1 mV or without in RCA occlusion patients were higher than those in LCX occlusion patients( P 0. 01 and P 0. 05),the occurrence rates of ST aVR down more than or equal to 0. 1 mV and ST V1down,ST V5 ST V6up in LCX occlusion patients were higher than those in RCA occlusion patients( P 0. 05). The sensitivity and specificity of ST V1down ST aVR up and down to less than 0. 1 mV or without in predicting RCA for infarct artery were 73. 1% 80. 8% and 6 /7 5 /7,respectively. The sensitivity and specificity of ST V1down,ST aVR down more than or equal to 0. 1 mV and ST V5 ST V6up in predicting LCX for infarct artery were 4 /7,4 /7 3 /7 and 84. 6%,86. 5% 92. 3%,respectively. Conclusions: The effects of analysing multiple lead changes of ECG and using various methods on predicting the related artery of inferior wall acute myocardial infarction are better than a single ECG standard.