Ecg Discrimination Between Right Coronary And Left Circumflex Coronary Arterial Occlusion In Patients With Acute Inferior Myocardial Infarction

The composite ECG criteria were useful in predicting the artery involved in AMI, although any single criterion was not sensitive or specific enough to differentiate RCA from LCX coronary artery occlusion (Dwyer et al., 1980, Wong and Freedman 2000). The 12-lead ECG is a cheap, easy, and readily obtainable diagnostic approach in discrimination of IRA and its culprit lesion segment (Kabakci et al., 2001The culprit vessel in AIMI may be either the RCA ( in 80 % of the cases) or the LCX (Zimetbaum and Josephson 2003). Our study aimed to assess the correlation between coronary angiographic findings and ST segment changes in AIMI Our study included 40 patients; 35 males and 5 females, their age ranged from 36 to 67 years. These patients admitted to Coronary Care Unit (C.C.U) at Zagazig University Hospital within 24 hours from the onset of chest pain. This study was done from September 2005 to March 2007Patients admitted with first attack of recent AIMI where definite diagnosis was established when at least 2 of the following criteria were present: chest discomfort 30 minutes compatible with myocardial ischemia, presence of an ST segment elevation 0.1 mV in 2 leads of ІІ, ІІІ, aVF in the admission ECG and typical increase in serum creatine kinas to more than twice the upper limit of normal. Patients who had the following criteria were excluded: bundle branch block, prior Q- wave myocardial infarction, prior coronary artery bypass graft operation and normal coronary angiography. All patients were subjected to full detailed history taking, complete physical examination, ECG, cardiac enzymes analysis, echocardiography and coronary angiography was done within 7 days of the onset of symptoms for detection of the culprit artery whether RCA or LCX .