Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusion
Abstract: Introduction: In some cases, ST segment elevation in right precordial leads in conjunction with inferior leads can be originated by an obstruction of the right coronary artery in its proximal portion, generating an inferior myocardial infarction which involves the right ventricle. Case presentation: We present the case of a 57-year-old male, which presents symptoms of acute coronary syndrome. The electrocardiogram shows subepicardial injury in anteroseptal leads (V1-V3) and elevation of ST segment in inferior leads (DIII, AVF). A coronariography is performed finding a complete obstruction of right coronary artery in the proximal portion, left coronary artery without lesions. Analysis: In right ventricular infarction or anteroseptal infarction, the ST segment vector always has a posterior- anterior direction in horizontal plane, the direction of this vector will produce an elevation of ST segment in leads V1 to V3 (even V4). Conclusion: It is necessary to do a correct analysis of the electrocardiogram for understanding the mentioned changes and to not assume that the electrocardiographic manifestations are a consequence of multivessel disease.
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Asociación Nacional de Cardiólogos de México, Sociedad de Cardiología Intervencionista de México
2017
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oai:scielo:S0188-219820170004002002022-04-20Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusionFélix-Bulman,Jorge AndrésAmador-Mena,José EduardoMacías-Garrido,Enrico Infarct electrocardiogram elevation vector Abstract: Introduction: In some cases, ST segment elevation in right precordial leads in conjunction with inferior leads can be originated by an obstruction of the right coronary artery in its proximal portion, generating an inferior myocardial infarction which involves the right ventricle. Case presentation: We present the case of a 57-year-old male, which presents symptoms of acute coronary syndrome. The electrocardiogram shows subepicardial injury in anteroseptal leads (V1-V3) and elevation of ST segment in inferior leads (DIII, AVF). A coronariography is performed finding a complete obstruction of right coronary artery in the proximal portion, left coronary artery without lesions. Analysis: In right ventricular infarction or anteroseptal infarction, the ST segment vector always has a posterior- anterior direction in horizontal plane, the direction of this vector will produce an elevation of ST segment in leads V1 to V3 (even V4). Conclusion: It is necessary to do a correct analysis of the electrocardiogram for understanding the mentioned changes and to not assume that the electrocardiographic manifestations are a consequence of multivessel disease.info:eu-repo/semantics/openAccessAsociación Nacional de Cardiólogos de México, Sociedad de Cardiología Intervencionista de MéxicoRevista mexicana de cardiología v.28 n.4 20172017-12-01info:eu-repo/semantics/reporttext/htmlhttp://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0188-21982017000400200en |
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Félix-Bulman,Jorge Andrés Amador-Mena,José Eduardo Macías-Garrido,Enrico |
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Félix-Bulman,Jorge Andrés Amador-Mena,José Eduardo Macías-Garrido,Enrico Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusion |
author_facet |
Félix-Bulman,Jorge Andrés Amador-Mena,José Eduardo Macías-Garrido,Enrico |
author_sort |
Félix-Bulman,Jorge Andrés |
title |
Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusion |
title_short |
Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusion |
title_full |
Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusion |
title_fullStr |
Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusion |
title_full_unstemmed |
Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusion |
title_sort |
electrocardiographic analysis of v1-v4 leads in infarction by proximal right coronary artery occlusion |
description |
Abstract: Introduction: In some cases, ST segment elevation in right precordial leads in conjunction with inferior leads can be originated by an obstruction of the right coronary artery in its proximal portion, generating an inferior myocardial infarction which involves the right ventricle. Case presentation: We present the case of a 57-year-old male, which presents symptoms of acute coronary syndrome. The electrocardiogram shows subepicardial injury in anteroseptal leads (V1-V3) and elevation of ST segment in inferior leads (DIII, AVF). A coronariography is performed finding a complete obstruction of right coronary artery in the proximal portion, left coronary artery without lesions. Analysis: In right ventricular infarction or anteroseptal infarction, the ST segment vector always has a posterior- anterior direction in horizontal plane, the direction of this vector will produce an elevation of ST segment in leads V1 to V3 (even V4). Conclusion: It is necessary to do a correct analysis of the electrocardiogram for understanding the mentioned changes and to not assume that the electrocardiographic manifestations are a consequence of multivessel disease. |
publisher |
Asociación Nacional de Cardiólogos de México, Sociedad de Cardiología Intervencionista de México |
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2017 |
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http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0188-21982017000400200 |
work_keys_str_mv |
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