Use of Indicative and Reciprocal Electrocardiographic Changes to Help Localize the Site of Coronary Occlusion

Dl, Glancy; Doghmi, W H

doi:10.1080/08998280.2001.11927740

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…A standard 12-lead electrocardiogram showed 1 mm of ST-segment elevation in lead III with slightly less elevation in lead aVF and <0.5 mm elevation in lead II (Figure 1). The reciprocal ST-segment depression noted in leads I and aVL confirmed that the minor ST-segment elevation in leads II, III, and aVF represented inferior acute myocardial injury (1).…”

Section: Electrocardiographic Reportsupporting

confidence: 52%

St-Segment Changes: Some Subtle, Some Obvious

Glancy¹,

Jones²

2006

Baylor University Medical Center Proceedings

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Section: Electrocardiographic Reportsupporting

confidence: 52%

St-Segment Changes: Some Subtle, Some Obvious

Glancy¹,

Jones²

2006

Baylor University Medical Center Proceedings

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“…Reciprocal changes such as ST depressions and TWI are well-recognized ECG changes that accompany ST elevations [ 5 , 6 ] and their significance has been the subject of many studies. These changes have been studied to localize the site of a coronary lesion [ 7 ] and also are believed to be early and sensitive markers of myocardial infarction [ 8 ]. Reciprocal changes may be the only manifestation of acute myocardial ischemia and may be present in a single lead as ST depression in lead aVL [ 5 , 6 ] and TWI in lead aVL indicating a significant coronary artery lesion in left anterior descending (LAD) artery is another example [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Isolated T Wave Inversion in Lead aVL: An ECG Survey and a Case Report

Hassen

Costea

Carrazco

et al. 2015

Emergency Medicine International

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Background. Computerized electrocardiogram (ECG) analysis has been of tremendous help for noncardiologists, but can we rely on it? The importance of ST depression and T wave inversions in lead aVL has not been emphasized and not well recognized across all specialties. Objective. This study's goal was to analyze if there is a discrepancy of interpretation by physicians from different specialties and a computer-generated ECG reading in regard to a TWI in lead aVL. Methods. In this multidisciplinary prospective study, a single ECG with isolated TWI in lead aVL that was interpreted by the computer as normal was given to all participants to interpret in writing. The readings by all physicians were compared by level of education and by specialty to one another and to the computer interpretation. Results. A total of 191 physicians participated in the study. Of the 191 physicians 48 (25.1%) identified and 143 (74.9%) did not identify the isolated TWI in lead aVL. Conclusion. Our study demonstrated that 74.9% did not recognize the abnormality. New and subtle ECG findings should be emphasized in their training so as not to miss significant findings that could cause morbidity and mortality.

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“…As it is possible to predict the localisation of a coronary artery that is affected by means of diagnosing acute myocardial infarction (MI) through looking at the elevations of ST-segment in ECG, it is also possible to predict the localisation of the coronary artery that is affected by reciprocal ECG changes including ST depression and T-wave inversion 1. Sometimes, the reciprocal changes can be the sole sign of acute MI.…”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic clue for a mid-LAD lesion

Doğanay

Onur

et al. 2016

BMJ Case Reports

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ECG is still the first diagnostic tool for coronary artery disease. It is possible to predict the localisation of affected vessel(s) through ST and T changes on ECG. Sometimes, reciprocal changes may be the only marker of acute myocardial ischaemia, as single T-wave inversion in lead aVL may represent a coronary artery lesion in the left anterior descending (LAD). A 49-year-old woman presented to the emergency department, with left-sided chest pain. Her initial ECG showed no ischaemic changes. On the third hour ECG there was T-wave inversion in leads aVL and V2, and troponin turned positive. Coronary angiography showed 90% mid-LAD occlusion. The importance of this case is that patients with ischaemic chest pain should be followed with serial ECG. Also, emergency physicians should be alert to identify new changes on ECG, as isolated T-wave inversion in lead aVL can be the only finding to take the patient into the catheterisation laboratory.

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Use of Indicative and Reciprocal Electrocardiographic Changes to Help Localize the Site of Coronary Occlusion

Cited by 5 publications

References 6 publications

St-Segment Changes: Some Subtle, Some Obvious

St-Segment Changes: Some Subtle, Some Obvious

Isolated T Wave Inversion in Lead aVL: An ECG Survey and a Case Report

Electrocardiographic clue for a mid-LAD lesion

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