Infarct-related-artery analysis of acute high lateral wall myocardial infarction

Objective To study the characteristics of infarct-related-artery (IRA) in acute high lateral wall myocardial infarction and to give clinical clue for deducing the location of coronary artery lesions. Methods Ninety-six patients with acute high lateral wall myocardial infarction (77 males, 19 females, mean age 57.3±10.7 years) were enrolled in the study. They all had infarction for the first time and were confirmed to have single vessel coronary artery disease by coronary angiography. The patients were divided into 3 groups according to the ECG changes at the onset of infarction. The first group (group A) was simple high lateral wall infartion (23 cases). The second one (group B) was high lateral with anterior wall infarction (58 cases, among them 27 cases with anteral-septal infarction and the other 31 with extensive anterior infarction). The third group (group C) was high lateral with lateral wall infarction (15 cases). Lesion characteristics of IRA were analyzed. Results The infarction-related lesions were mainly on left anterior descending arteries in group B (56/58), and on left circumflex in group C (13/15). But those in group A could be on either diagonal (12/23) or left circumflex (11/23). The difference of distribution of IRA among these groups was statistically significant (P0.001). There were more patients with occlusive lesion in group B (39/58). The lesion location and percentage of occlusive lesion were similar between the patients with high lateral plus anteral-septal infarction and those with high lateral plus extensive anterior wall infarction. But the former had better collaterals (14/27 vs 7/31, P0.05). Conclusion The location of infarction-related lesions can be deduced from the ECG changes at the onset of high lateral wall infarction. And infarction area can be limited by better collaterals.