Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
November 2017 Vol. 6(11), pp. 310-315
Copyright © 2017 Global Advanced Research 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

*Corresponding Author E-mail: lshankar2@hotmail.com; Phone: 9845112909

Accepted 25 July, 2017

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).

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