Title: Electrocardiographic presentation of diagonal and marginal branches occlusion as infarct-related artery
- Filip Szymański, Marcin Grabowski, Grzegorz Karpiński, Krzysztof J. Filipiak, Przemysław Stolarz, Zenon Huczek, Janusz Kochman, Grzegorz Horszczaruk, Anna Hrynkiewicz, Grzegorz Opolski
- Original articles
- Polish Journal of Cardiology
- Start page:
- Final page:
- acute coronary syndrome, diagonal branch, marginal branch, electrocardiographic changes
Introduction: The previous studies supplied information on electrocadiographic indicators of the main branches of the coronary artery as infarct related arteries (IRA) in patients (pts) with acute coronary syndrome (ACS) myocardial infarction. There is no evidence for electrocardiographic changes characteristic for the diagonal (GD) and marginal (GM) branches of the left coronary artery as IRA.
Aim of study: The aim of the study was to analyze electrocadiographic changes in pts with ACS who had the myocardial infarction due to the occlusion of GD or GM.
Materiał and methods: From the registry of 400 consecutive pts with ACS, treated with the primary angioplasty, we selected 13 pts with GD and 12 with GM. The baseline electrocardiograms were evaluated. Results: The most characteristic changes for acute occlusion of GD observed in 12 (92.3%) pts were: ST ele-vation in V2andV3; (mean 1.2±0.5 mm, maximum 1.7 mm) and STdepression in II, III (mean 0.9±0.4 mm; maximum 1.5 mm). The most characteristic changes for acute occlusion of GM, observed in 64% of patients were: ST depression in V5 and V6 (mean 0.9±0.4 mm, maximum 1 mm) and ST depression in II and aVF (mean 0.7±0.2 mm, maximum 0.8 mm).
Conclusions: The electrocardiographic presentation of GD occlusion is similarto that observed in occlusion of left anterior descending coronary artery and presentation of GM occlusion is not similar to that observed the left circumflex coronary artery. ST segment deviations are slight and usually less than 1 mm. The pts presented with chest pain and borderline ST segment deviations should be diagnosed for occlusion of GM orGM.