Transient ST-segment elevation in lead aVR associated with tako-tsubo cardiomyopathy

Clinical Utility of aVR—The Neglected Electrocardiographic Lead

“…PR segment depression in lead aVR combined with PR segment elevation in the inferior leads was described in association with tension pneumothorax 48 . We found a case report of Takotsubo cardiomyopathy presenting with transient ST segment elevation in lead aVR 49 …”

Tako-Tsubo Cardiomyopathy: A Recent Clinical Syndrome Mimicking an Acute Coronary Syndrome

“…ST-segment is reported in approximately 30 to 50% of the TCC patients (Sharkey et al 2010;Abe et al, 2003;Akashi et al, 2005;Kurisu et al, 2002;Elesber et al, 2007;Sato et al, 2006;Tsuchihashi et al, 2001;Dib et al, 2009). Moreover, transient ST-segment isolated elevation in lead aVR has also been described in the TTC patients (Rostoff et al, 2009). The next most common ECG characteristic in TTC are deep T wave inversions, especially in precordial leads, and frequently associated with corrected QT interval prolongation.…”

“…Furthermore, these corrected QT interval prolongations have been noted to be correlated with highest occurrence of ventricular fibrillation and extent of wall motion abnormalities in acute coronary syndrome patients (Yunus et al, 1996;Stajer et al, 1993). Transient pathological Q waves may rarely develop in TTC patients (Rostoff et al, 2009;Krishnan et al, 2009;Kim et al, 2010;Silva et al, 2009). Moreover, a new bundle-branch block or a normal ECG may be found at presentation Bybee et al,.…”

Acute myocardial infarction with significant left main coronary artery stenosis, significant 3-vessel coronary artery disease and elevated troponin-I at admission

“…Lead aVR and lead v1 ST segment elevation has been reported, during an attack of chest pain [2], in patients with LMCA disease [3,4] with ST segment depression in leads V3, V4 and V5 (with maximal depression in V4) [5][6][7][8][9]. ST-segment elevation in lead aVR in patients with angina at rest can be related to transmural ischemia of the basal part of the interventricular septum, frequently due to LMCA or multivessel coronary disease [10] too. 3-vessel coronary artery disease(CAD) [11,12] and LMCA disease [9] show a frequent combination of leads with abnormal ST segments during chest pain with ST-segment depression in leads I II V4-V6, and ST-segment elevation in lead aVR [3].…”