| Home | E-Submission | Sitemap | Contact Us |  
top_img
J Korean Soc Emerg Med > Volume 14(5); 2003 > Article
Journal of The Korean Society of Emergency Medicine 2003;14(5): 658-665.
Accuracy of the Electrocardiographic Criteria for Predicting the Right or Left Circumflex Coronary Artery as the Culprit Coronary Artery in Acute Inferior Myocardial Infarction
Soon Bong Jang, Hyuk Joong Choi, Tai Ho Im, Jin Ho Sin
1Department of Emergency Medicine, Hanyang University, School of Medicine, Seoul, Korea. erthim@hanyang.ac.kr
2Department of Internal Medicine, Hanyang University, School of Medicine, Seoul, Korea.
ABSTRACT
PURPOSE:
New electrocardiographic criteria to predict the culprit coronary artery in acute inferior myocardial infarction have been developed. We tested the effectiveness of these criteria by verifying their diagnostic accuracy.
METHODS:
The seven electrocardiographic criteria are STsegment depressions (1) in leads I > 0.5 mm, (2) in aVL > 1 mm, and (3) in V6 under the isoelectric line; higher ST-segment elevations (4) in lead III than in lead II, (5) in V1 than in V6, (6) in the sum of V(1 + 2 + 3) > or = V(4 + 5 + 6); and (7) ST-segment elevation > 1 mm in V1, and were analyzed by comparing the ST-segment deviation with the location of the infarcted coronary artery in 43 patients with acute inferior myocardial infarction.
RESULTS:
The culprit coronary artery consisted of the right coronary artery in 72.1% of the cases, the left circumflex artery in 23.3% of the cases, and the left anterior descending artery in 4.6% of the cases. There was a significant correlation between the criteria and the culprit coronary artery, except for two criteria, ST-segment depression in lead I > 0.5 mm and elevation in lead V1 > 1 mm (p=0.00 to 0.02). Criteria such as ST-segment depressions in lead aVL > 1 mm and V6 under the isoelectric line and a higher ST-segment elevation in the sum of V(1 + 2 + 3) > or = V(4 + 5 + 6) had relatively high specificities (80%, 100%), but a low sensitivities (51.6%, 67.7%). Criteria such as higher ST-segment elevations in lead III than in II and in V1 than in V6 had not only high sensitivities (80.6%, 100%) and specificities (70%, 90%) but also relatively high diagnostic accuracies (95.1%, 82.9%).
CONCLUSION:
Higher ST-segment elevations in lead III than in II and in V1 than in V6 are sensitive & specific criteria for correctly predicting the culprit coronary artery in acute inferior myocardial infarction.
Key words: Myocardial infarction, Electrocardiogram, Coronary artery
TOOLS
PDF Links  PDF Links
Full text via DOI  Full text via DOI
Download Citation  Download Citation
CrossRef TDM  CrossRef TDM
  E-Mail
Share:      
METRICS
370
View
0
Download
Related article
Editorial Office
The Korean Society of Emergency Medicine
101-3104, Brownstone Seoul, 464 Cheongpa-ro, Jung-gu, Seoul 06351, Korea
TEL: +82-51-240-7503   FAX: +82-51-253-6472   E-mail: pnuhem@daum.net
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Copyright © The Korean Society of Emergency Medicine. All rights reserved.