BACKGROUND: To diagnose left main trunk (LMT) infarction by 12-lead standard electrocardiogram (ECG) is an important emergency technique, but the features in LMT infarctions have not been clarified. METHODS AND RESULTS: The study enrolled 140 subjects who were divided into 4 groups according to the location of the culprit artery: 35 with LMT, 35 with left anterior descending artery (LAD), 35 with right coronary artery and 35 with left circumflex artery. Various parameters obtained from the ECGs were analyzed. Average QTc interval (0.51 +/- 0.06 s) in LMT group was markedly longer than that in the 3 other groups. Average QRS axis (-10 +/- 77 degrees) in LMT infarction showed a remarkable left deviation. ST-segment elevation in lead aVR occurred in 28 patients (80.0%) in the LMT group. The ECG features of the LMT group could be classified into 2 main groups: right bundle branch block (RBBB) with a marked left axis deviation (RBBB + LADEV type) and ST-segment elevation in leads V2-5, I and aVL without abnormal axis deviation (LAD type). CONCLUSION: Either ST-segment elevation in lead aVR and marked prolongation of both the QRS width and QTc interval with a prominent abnormal axis deviation or ST-segment elevation in the broad anterior precordial lead with a normal QRS axis strongly suggests LMT infarction.
BACKGROUND: To diagnose left main trunk (LMT) infarction by 12-lead standard electrocardiogram (ECG) is an important emergency technique, but the features in LMT infarctions have not been clarified. METHODS AND RESULTS: The study enrolled 140 subjects who were divided into 4 groups according to the location of the culprit artery: 35 with LMT, 35 with left anterior descending artery (LAD), 35 with right coronary artery and 35 with left circumflex artery. Various parameters obtained from the ECGs were analyzed. Average QTc interval (0.51 +/- 0.06 s) in LMT group was markedly longer than that in the 3 other groups. Average QRS axis (-10 +/- 77 degrees) in LMT infarction showed a remarkable left deviation. ST-segment elevation in lead aVR occurred in 28 patients (80.0%) in the LMT group. The ECG features of the LMT group could be classified into 2 main groups: right bundle branch block (RBBB) with a marked left axis deviation (RBBB + LADEV type) and ST-segment elevation in leads V2-5, I and aVL without abnormal axis deviation (LAD type). CONCLUSION: Either ST-segment elevation in lead aVR and marked prolongation of both the QRS width and QTc interval with a prominent abnormal axis deviation or ST-segment elevation in the broad anterior precordial lead with a normal QRS axis strongly suggests LMT infarction.
Authors: Zhan Zhong-Qun; Yang Bo; Kjell C Nikus; Andrés Ricardo Pérez-Riera; Wang Chong-Quan; Wang Xian-Ming Journal: Ann Noninvasive Electrocardiol Date: 2013-11-08 Impact factor: 1.468
Authors: Petr Widimsky; Filip Rohác; Josef Stásek; Petr Kala; Richard Rokyta; Boyko Kuzmanov; Martin Jakl; Martin Poloczek; Jan Kanovsky; Ivo Bernat; Ota Hlinomaz; Jan Belohlávek; Ales Král; Vratislav Mrázek; Vladimir Grigorov; Slaveyko Djambazov; Robert Petr; Jiri Knot; Dana Bílková; Michaela Fischerová; Karel Vondrák; Marek Maly; Alena Lorencová Journal: Eur Heart J Date: 2011-09-01 Impact factor: 29.983
Authors: James McKinney; Ian Pitcher; Christopher B Fordyce; Masoud Yousefi; Tee Joo Yeo; Andrew Ignaszewski; Saul Isserow; Sammy Chan; Krishnan Ramanathan; Carolyn M Taylor Journal: PLoS One Date: 2016-07-28 Impact factor: 3.240