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Article: Angiographic and clinical implications of combined ST-segment elevation in anterior and inferior leads in acute myocardial infarction

TitleAngiographic and clinical implications of combined ST-segment elevation in anterior and inferior leads in acute myocardial infarction
Authors
KeywordsAcute coronary care
Ambulatory electrocardiogram
Cardiac diagnostic/interventional catheterization
Electrocardiography
Issue Date2009
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
Citation
Clinical Cardiology, 2009, v. 32 n. 1, p. 21-27 How to Cite?
AbstractBackground: The clinical and angiographic findings of patients suffered from acute myocardial infarction (MI) and presented with combined ST elevation in both anterior and inferior leads remain unclear. Hypothesis: These patients might have ≥1 coronary arteries occluded. Methods: From January 2002 to December 2006, 49 consecutive patients were found to have ST elevation in both anterior and inferior leads during myocardial infarction. Patients who had left circumflex artery occlusion (acute or chronic) were excluded. These patients were divided into 4 types according to the infarct-related artery (IRA) and status of the contralateral vessel patency: left anterior descending artery (LAD) as the IRA with a patent right coronary artery (RCA) (type 1A, n = 25); LAD as IRA with an occluded RCA (type 1B, n = 1); RCA as IRA with a patent LAD (type 2A, n = 19); and RCA as IRA with an occluded LAD (type 2B, n = 4). Results: Single vessel occlusion (type A angiographic pattern) was found in 90% of patients. Type 1A patients had a larger infarct size than that of 2A. ST elevation in V2 ≥ V3 identified RCA as the IRA with a high specificity (92%) and sensitivity (74%). Type 2B patients (2-vessel occlusion) had a larger infarct size than that of 2A; however, no electrocardiogram (ECG) criteria could reliably differentiate them. Conclusion: In a real world situation, single vessel occlusion is found in the majority of cases of combined ST elevation in anterior and inferior leads. ST elevation in V2 ≥ V3 distinguishes RCA against LAD as the IRA with high accuracy. © 2009 Wiley Periodicals, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/59152
ISSN
2015 Impact Factor: 2.431
2015 SCImago Journal Rankings: 1.309
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorJim, MHen_HK
dc.contributor.authorChan, AOOen_HK
dc.contributor.authorTang, MOen_HK
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorLee, SWLen_HK
dc.contributor.authorLau, CPen_HK
dc.date.accessioned2010-05-31T03:43:53Z-
dc.date.available2010-05-31T03:43:53Z-
dc.date.issued2009en_HK
dc.identifier.citationClinical Cardiology, 2009, v. 32 n. 1, p. 21-27en_HK
dc.identifier.issn0160-9289en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59152-
dc.description.abstractBackground: The clinical and angiographic findings of patients suffered from acute myocardial infarction (MI) and presented with combined ST elevation in both anterior and inferior leads remain unclear. Hypothesis: These patients might have ≥1 coronary arteries occluded. Methods: From January 2002 to December 2006, 49 consecutive patients were found to have ST elevation in both anterior and inferior leads during myocardial infarction. Patients who had left circumflex artery occlusion (acute or chronic) were excluded. These patients were divided into 4 types according to the infarct-related artery (IRA) and status of the contralateral vessel patency: left anterior descending artery (LAD) as the IRA with a patent right coronary artery (RCA) (type 1A, n = 25); LAD as IRA with an occluded RCA (type 1B, n = 1); RCA as IRA with a patent LAD (type 2A, n = 19); and RCA as IRA with an occluded LAD (type 2B, n = 4). Results: Single vessel occlusion (type A angiographic pattern) was found in 90% of patients. Type 1A patients had a larger infarct size than that of 2A. ST elevation in V2 ≥ V3 identified RCA as the IRA with a high specificity (92%) and sensitivity (74%). Type 2B patients (2-vessel occlusion) had a larger infarct size than that of 2A; however, no electrocardiogram (ECG) criteria could reliably differentiate them. Conclusion: In a real world situation, single vessel occlusion is found in the majority of cases of combined ST elevation in anterior and inferior leads. ST elevation in V2 ≥ V3 distinguishes RCA against LAD as the IRA with high accuracy. © 2009 Wiley Periodicals, Inc.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.orgen_HK
dc.relation.ispartofClinical Cardiologyen_HK
dc.subjectAcute coronary careen_HK
dc.subjectAmbulatory electrocardiogramen_HK
dc.subjectCardiac diagnostic/interventional catheterizationen_HK
dc.subjectElectrocardiographyen_HK
dc.subject.meshAgeden_HK
dc.subject.meshCoronary Angiographyen_HK
dc.subject.meshElectrocardiographyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMyocardial Infarction - physiopathology - radiographyen_HK
dc.subject.meshSensitivity and Specificityen_HK
dc.titleAngiographic and clinical implications of combined ST-segment elevation in anterior and inferior leads in acute myocardial infarctionen_HK
dc.typeArticleen_HK
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/clc.20303en_HK
dc.identifier.pmid19143001-
dc.identifier.scopuseid_2-s2.0-58449097677en_HK
dc.identifier.hkuros158899en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-58449097677&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume32en_HK
dc.identifier.issue1en_HK
dc.identifier.spage21en_HK
dc.identifier.epage27en_HK
dc.identifier.isiWOS:000262559400004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridJim, MH=6603860344en_HK
dc.identifier.scopusauthoridChan, AOO=7403167965en_HK
dc.identifier.scopusauthoridTang, MO=7401973887en_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridLee, SWL=7601396808en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK

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