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KMID : 0385920140250030284
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Journal of the Korean Society of Emergency Medicine
2014 Volume.25 No. 3 p.284 ~ p.290
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Feature of Electrocardiography Presented Stenosis of Proximal Right Coronary Artery
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Choi Jae-Young
Lee Jae-Hoon
Jeong Jin-Woo
Chung Jun-Young
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Abstract
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Purpose: Prediction of the proximal right coronary artery (pRCA) through electrocardiography (ECG) is very important because pRCA occlusion has frequently been suspected in right ventricular infarction, which has a high mortality rate. The aim of this study is to investigate characteristic ECG finding of pRCA occlusion distinguishable from mid or distal RCA.
Methods: A review was conducted retrospectively of 630 patients with chest pain in the ED who underwent coronary angiography (CAG) from June 2007 to December 2013 and CAG of 89 among them resulted in only RCA occlusion exempting other coronary vessels. The patients were divided into two groups: subjects with pRCA (n=32) occlusionand below the mid RCA (n=57) occlusion. In each subset, features of ECG were searched and analyzed.
Results: ECG of patients with occlusion of the pRCA showed more prominent ST depression in lead I (-0.68 mm vs -0.22 mm, p=0.027) and ST elevation in V1 (0.94 mm vs 0.09 mm, p=0.001) than in the below portion. Both ST depression (≤0 mm) in I and ST elevation (>0.5 mm) in V1 classified according to cutoff value using Youden index J were closely related to pRCA occlusion other than mid or distal RCA (OR 7.16, p<0.001).
Conclusion: Discrimination of pRCA occlusion from mid or distal RCA in ECG through ST depression in lead I and ST elevation in lead V1 might be valid as a sentinel of right ventricular infarction.
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KEYWORD
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Coronary artery disease, Myocardial infarction, Electrocardiography, Coronary angiography
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