Myocardial Reperfusion by Thrombolysis After Acute Total Left Main Artery Occlusion—A Case Report

Finzi, L A; Secches, Antonio L.; Évora, Paulo Roberto Barbosa; Ribeiro, Patrícia Lisbôa Izetti; Ferez, Marcus Antônio; Amaral, Fernando

doi:10.1177/000331978703800510

Cited by 7 publications

(1 citation statement)

References 6 publications

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“…A total of 34 patients with acute LMCA occlusion have been described in 11 reports. 6,7,[11][12][13][14][15][16][17][18][19] ST segment depression in the precordial leads was reported in 12 patients. According to Sclarovsky, et al manifestation of LMCA stenosis is diffuse ST segment depression over the inferior leads and the precordial leads except V 2 and V 3 on ECG, as in this series.…”

Section: Discussionmentioning

confidence: 99%

Reciprocal Changes in 12-Lead Electrocardiography Can Predict Left Main Coronary Artery Lesion in Patients With Acute Myocardial Infarction

Jong

Chou³

et al. 2006

Int. Heart J.

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SUMMARYAcute left main coronary artery (LMCA) occlusion may result in acute myocardial infarction (AMI) or sudden death. ST elevation in the aVR and V1 leads is reported to be valuable in recognizing LMCA occlusion. Early recognition of electrocardiogram (ECG) changes, such as reciprocal ST depression in other leads, is helpful in averting this disaster. This study aimed to determine the reciprocal ST segment depression of 12-lead ECGs associated with acute LMCA occlusion. From January 2000 to December 2004, 61 patients who underwent emergency percutaneous coronary intervention in 3 hospitals due to AMI associated with LMCA (n = 18) and a left anterior descending coronary artery (LADCA) (n = 43) proximal lesion were selected. Reciprocal ST segment depression occurred in leads aVF, V 2 , V 3 , V 4 , V 5 , and V 6 with significantly higher incidence in the LMCA group than in the LADCA group. Stepwise linear multivariate discriminant analysis indicated that ST segment depression in leads aVF, V 2 , and V 4 could distinguish the LMCA group from the LADCA group. We concluded that reciprocal ST segment depression in leads V 2 , V 4 , and aVF of a 12-lead ECG is an important predictor of acute LMCA occlusion. (Int Heart J 2006; 47: 13-20) Key words: Reciprocal change, ST segment depression, Acute left main occlusion, Acute myocardial infarction ACUTE LMCA occlusion is a serious clinical condition. Despite its low incidence, the prognosis is often poor. The condition is usually discovered too late for surgery to be initiated, therefore, vessel patency is usually obtained by percutaneous coronary intervention.1,2) Unfortunately, this modality is associated with a high mortality rate. Early recognition and faster percutaneous coronary intervention may decrease the mortality rate.

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Section: Discussionmentioning

confidence: 99%

Reciprocal Changes in 12-Lead Electrocardiography Can Predict Left Main Coronary Artery Lesion in Patients With Acute Myocardial Infarction

Jong

Chou³

et al. 2006

Int. Heart J.

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Survival after myocardial infarction caused by acute left main coronary artery occlusion: Case report and review of the literature

Cohen¹,

Ferguson²

1989

Cathet. Cardiovasc. Diagn.

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We report a 44-year-old white male presenting with an acute anterior myocardial infarction. Cardiac catheterization at 2 weeks postinfarction revealed total occlusion of the left main coronary artery. There was a normal dominant right coronary artery supplying moderate collaterals to the left coronary system. The patient was managed with conservative therapy and was N.Y.H.A. functional class II on followup 2 years later. A review of the literature relative to myocardial infarction caused by acute left main coronary artery occlusion is presented, and unique features of these cases are described.

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A new electrocardiographic criteria for emergent reperfusion therapy

Hennings

Fesmire

2012

The American Journal of Emergency Medicine

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Myocardial Reperfusion by Thrombolysis After Acute Total Left Main Artery Occlusion—A Case Report

Cited by 7 publications

References 6 publications

Reciprocal Changes in 12-Lead Electrocardiography Can Predict Left Main Coronary Artery Lesion in Patients With Acute Myocardial Infarction

Reciprocal Changes in 12-Lead Electrocardiography Can Predict Left Main Coronary Artery Lesion in Patients With Acute Myocardial Infarction

Survival after myocardial infarction caused by acute left main coronary artery occlusion: Case report and review of the literature

A new electrocardiographic criteria for emergent reperfusion therapy

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