ISSN 3428-1576
Global Journal of Cardiology Vol. 8 (1), pp. 001-006, January, 2023. © International Scholars Journals
Full Length Research Paper
ST Segment Elevation in Leads V5 and V6 for Predicting Culprit Artery in Acute Inferior Wall Myocardial Infarction
Madhu Gupta1, Maheshwar Prasad2, Sun Jian1, Rajesh Panjiyar3, Shankar Laudari3* and G Subramanyam3
1Cardiovascular Disease Center, The first hospital of Jilin University, Norman Bethune College of Medicine, Changchun, PR China, 130021
2Department of Medicine, National Medical College, Nepal
3Department of Cardiology, College of Medical Science, Nepal.
Accepted 15 September, 2022
Abstract
ST elevation (ST↑) in the leads V5 and V6 to predict the culprit and furthermore, comparing the degree of ST ↑ in lead V6 with that in lead III. Patients were first divided according to the presence (n-62) and absence (n-98) with ST ↑ of ≥2 mm in leads V5 and V6, the patients were then further subdivided into the 2 groups according to the degree of ST ↑ in lead III and in lead V6 and were compared with coronary angiography. In patients with ST ↑ in leads V5 and V6, the infarct related artery was right coronary artery (RCA) in 66% and left circumflex artery (LCx) in 31%. The RCA was found significantly higher proportion in ST ↑ in leads V5 and V6 with ST ↑ in lead III>V6 (n-37; 82%) (p=0.0001), whereas the LCx disease in ST↑ in leads V5 and V6 with ST ↑ in III≤V6 (n-12; 71%) (p-0.0001). The sensitivity, specificity, positive and negative predictive value in ST ↑ in leads V5 and V6 with ST ↑ in lead III>V6 for RCA, and ST ↑ in lead III≤V6 for LCx to predict culprit artery were 90%, 63%, 84%, 75% and 63%, 90%, 75%, 84% respectively. ST elevation in leads V5 and V6 suggests a greater risk area in patient with acute inferior wall myocardial infarction. It also signifies a larger perfusion territory and demands for more aggressive reperfusion therapy.
Keywords: Infarct related artery (IRA); ST elevation myocardial infarction (STEMI); Right coronary artery (RCA); Left circumflex artery (LCX); Electrocardiogram (ECG).