Combined anterior and inferior ST-segment elevation. Electrocardiographic differentiation between right coronary artery occlusion with predominant right ventricular infarction and distal left anterior descending branch occlusion.

摘要

Alzand and Gorgels1 studied whether there are electro-cardiographic characteristics that may help in differentiating between acute ST-segment elevation myocardial infarction (STEMI) due to proximal right coronary artery (RCA) occlusion and distal left anterior descending (LAD) coronary occlusion among patients presenting with ST elevation in both the precordial and inferior leads. The authors retrospectively compared the electrocardiograms (ECGs) of 7 patients with acute RCA infarction to those of 5 patients with distal LAD occlusion. Overall, the analysis is interesting; however, unfortunately the number of patients in each group is very small. Moreover, 1 of the 7 patients with RCA infarction did not have ST elevation in the inferior leads (patient lc).