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KMID : 0616619970030010173
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Journal of Soonchunhyang Medical College
1997 Volume.3 No. 1 p.173 ~ p.179
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Prognostic Significance of Maximal Precordial ST-Segment Depression in Patients with Inferior Wall Acute Myocardial Infarction
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Abstract
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Background : The clinical implication of precordial ST-segment depression during acute inferior myocardial infarction are controversal. But it is widely accepted that ST-segment depression in precordial leads is associated with high rate of complications. There has been some reports that patients with inferior wall infarction and maximal ST-segment depression in leads V4 to V6 harbor an increased risk for hospital mortality.
Method : Clinical characteristics, electrocardiograms,hemodynamic findings and coronary angiographic findings were reviewed in 34 patients with acute inferior myocardial infarction. Patients were classified into 3 types based on their pattern of ST-segment depression in precordial leads.(Group Ⅰ : no ST depression, Group Ⅱ : maximal ST depression in Ⅴ1 to Ⅴ3, Group Ⅲ : maximal ST depression in Ⅴ4 to Ⅴ6)
Result : There was no significant difference in demographic data of the patients except LDH, which tended to be higher in group Ⅲ than group Ⅰ. Patients in group Ⅲ presented lower mean aortic pressure and higher pulmonary wedge pressure. The prevalence of left anterior descending coronary stenosis and three vessel disease were more frequent in group Ⅲ than group Ⅰ.
Conclusion : Patients with acute inferior myocardial infarction and maximal precordial ST-segment depression in leads Ⅴ4 to Ⅴ6 had more extensive myocardial damage probably due to concomittant left anterior descending coronary artery disease.
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