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J Korean Soc Emerg Med > Volume 25(2); 2014 > Article
Journal of The Korean Society of Emergency Medicine 2014;25(2): 210-214.
Acute Myocardial Infarction with Elevated ST-segment Only in Lead aVR
Taek Geun Ohk, Gu Hyun Kang, Jung Rae Cho, Yong Soo Jang, Hee Cheol Ahn, Gyu Jong Cho, Jung Hwan Ahn, Jun Hwi Cho
1Department of Emergency Medicine, Kangnam Sacred Hospital, Hallym University, Korea. drkang9@hanmail.net
2Division of Cardiology, Department of Internal Medicine, Kangnam Sacred Hospital, Hallym University, Korea.
3Department of Emergency Medicine, Sacred Hospital, Hallym University, Korea.
4Department of Emergency Medicine, Kangdong Sacred Hospital, Hallym University, Korea.
5Department of Emergency Medicine, Kangwon National University Hospital, Korea.
ABSTRACT
Lead aVR ST segment elevation in patients with clinically suspected acute coronary syndrome strongly suggests the possibility of occlusion of the left main coronary artery (LMCA), and stenosis or occlusion in this area can cause severe life-threatening left ventricular dysfunction or malignant arrhythmias. Thus, it could be a sign suggestive of a poor prognosis for patients. In this study, we report on the case of a 67-year-old male who presented to the emergency department with total occlusion of LMCA with ST-segment elevation in only lead aVR, and without ST-segment elevation in other leads.
Key words: Electrocardiography, Acute coronary syndrome, Prognosis
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