• H Blanke, M Cohen, G U Schlueter, K R Karsch, and K P Rentrop.
• Z Kardiol. 1985 Mar 1; 74 (3): 157-64.

AbstractOne hundred and fifty-two patients underwent cardiac catheterization and coronary arteriography within 6.3 +/- 6.0 hours from onset of acute myocardial infarction. All had a standard 12-lead electrocardiogram recorded within 1.5 hours of cardiac catheterization. The electrocardiographic abnormalities present were correlated with the infarct related artery as determined by coronary arteriography. ST segment elevation was the most common finding in patients with the left anterior descending (LAD), or right coronary artery (RCA) as the infarct related artery. ST segment depression was the most common abnormality in patients with left circumflex artery (CX) as the infarct related artery. A typical pattern of anterior acute myocardial infarction was seen in 93% of all patients with the LAD as the infarct related artery. A typical pattern of acute inferior myocardial infarction was seen in 53% of all patients with RCA or CX narrowing taken as one group. The pattern of true posterior or posterolateral wall acute myocardial infarction in the absence of typical changes in the inferior leads was highly specific and predictive of CX narrowing. In contrast, the pattern of an inferior wall myocardial infarction, in the absence of true posterior or lateral wall changes, was highly specific and predictive of right coronary artery narrowing. Fifty-six percent of patients with CX artery as the infarct related artery presented with non-classical electrocardiographic abnormalities. The electrocardiographic pattern in patients with subtotal occlusions were similar to those of patients with total occlusions. Thus the electrocardiogram obtained in the first few hours of acute myocardial infarction is reliable in localizing the LAD as the infarct related artery.(ABSTRACT TRUNCATED AT 250 WORDS)

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