Prediction of an Infarct Related Artery on Electrocardiogram and its Correlation with Coronary Angiography in an Acute Myocardial Infarction

Abstract

Aim: To Predict an infarct related artery on Electrocardiogram and its correlation with Coronary angiography in an Acute myocardial Infarction. Materials and Methods: The study was carried out as a prospective observational study of 70 patients at medical college & tertiary health care Centre, over a period of two years that included cases of patients diagnosed to have acute myocardial infarction on ECG for the first time & have also undergone coronary angiography. Results: Study showed most common age group amongst study population was 51 to 60 yrs (42.9%) followed by 61 to 70 yrs (37.1%). LAD (71%) was the most common coronary artery amongst study population followed by RCA (25%) and LCX (4%). Most of the study population had ECG findings like ST depression III + aVF ≥ 2.5 (36%) and ST segment in III and aVF isoelectric or elevated (36%) followed by ST depression in III + aVF ≤ 2.5 and ≥ 0.5 (28%) in LAD occlusion. In the present study, most of the study population had ECG findings like ST↑LIII > ST↑ LII > 1 (94.12%), ST↓LI, aVL (82.35%) and ST↑V4R > 1 mm (70.59%) in RCA occlusion. In the present study, most of the study population had ECG findings like ST ↑ LII > LIII (100%) and Isoelectric or ST ↑ I,aVL (66.7%) in LCX occlusion. Conclusion: ECG criteria have excellent sensitivity and specificity in predicting the culprit artery Anterior ST elevation identified all patients with LAD as the culprit artery with 100 % accuracy in our study population. In patients with inferior ST elevation, relative ratio of ST elevation in lead II and lead III, correctly identified the culprit artery as RCA or LCx with 100 % accuracy. (ST elevation in lead II > III predicts LCx occlusion and the reverse predicts RCA occlusion.