ST SEGMENT DEPRESSION IN ANTERIOR CHEST LEADS V1-V6 IN CASE OF ACUTE INFERIOR MYOCARDIAL INFARCTION
Dr. Mohammad Aminul Islam*, Dr. Prof. AHK Chowdhury, Dr. Prof. AKM Mujibur Rahman and Dr. Md. Khalequzzaman
Background: Though precordial ST segment depression is debated for long time, preceding various researches has showed that precordial ST segment depression along with acute Inferior Myocardial Infarction independent to left coronary artery stenosis or extension of inferior ischemia. However purpose of the different pattern of precordial ST segments depression is a review study. Objective: In this study our main goal is to determine ST segment depression in anterior chest leads V1-V6 in case of acute inferior myocardial infarction. Methods: We examined enlisted eighty four (n=84) consecutive patients with acute inferior myocardial infarction within 12 hours of onset of chest pain and underwent thrombolysis in coronary care unit. Consequently patients were classified in two groups on the basis of admission electrocardiogram. Group A patients with acute inferior myocardial infarction associated significant (≥ 0.1 mV) precordial ST segment depression in leads V1-V6 (n=44, 52.38%); whereas group B had no remarkable precordial ST segment change (n=40, 47.62%). Thereafter Echocardiography was recorded within 3rd day and catheterization with coronary angiography was done within 4 weeks of infarction. Result: Patients with anterior ST segment deviation in association with acute inferior myocardial infarction (group A) had larger wall motion abnormality with posterior or lateral wall extension and Ejection Fraction (EF%) lower (50.47 ± 4.18 Vs55.25 ± 4.32, p=0.001) than that of patients with no precordial ST change (group B). Serum level of Troponin-I (34.25 ± 18.35 Vs 32.86 ± 7.12, p=0.721) and CK-MB (117.15 ± 40.49 Vs 97.65 ± 7.06, p=0.012) both were higher in group A rather than group B. Conclusion: In overall outcome, patients with ST segment depression in acute inferior myocardial infarction liked with more wideness of ischemic area of infracted zone and more prevalence to multi vessel lesion (double or triple vessel) and index of worse prediction.
Keywords: Myocardial infarction, ST segment, electrocardiograph, anterior ischemia.
[Full Text Article]