Acute coronary syndromes with ST-segment elevation

Acute coronary syndromes with ST-segment elevation... 

Figure 4.10 In an acute coronary syndrome with ST-segment elevation in V1-V2 to V4-V6 as the most striking pattern, the occluded artery is the left anterior descending coronary artery (LAD). The correlation of the ST-segment elevation in V1-V2 to V4-V5 with the ST morphology in II, III and VF allows us to know if it is an occlusion proximal or distal to D1 (see Figure 4.43). If it is proximal, the involved muscular mass in the anterior wall is large and the injury vector is directed not only forward but also upward, even though there can be a certain...

Figure 4.11 In an acute coronary syndrome with ST-segment elevation in II, III and VF as the most striking abnormality, the study of the ST-segment elevation and depression in different leads will allow us to assure if the occluded artery is RCA or LCX and even the site of the occlusion and its anatomical characteristics (dominance, etc ). This figure shows that the presence of ST-segment depression in lead I means that this lead is facing the injury vector tail that is directed to the right and, therefore, the...

Figure 4.16 Acute myocardial infarction in a patient with rapid atrial fibrillation. The ECG shows ST-segment elevation in V2-V5, I and VL. Leads II, III, and VF present an evident ST-segment depression as a mirror pattern of ST-segment elevation in precordial leads. This is a pattern of acute coronary syndrome with ST-segment elevation of the anterior wall according to the classical classification.

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