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Electrocardiographic changes of ST-elevation myocardial infarction in patients with complete occlusion of the left main trunk without collateral circulation: differential diagnosis and clinical considerations.

Abstract：

:Acute coronary syndromes due to involvement of the left main trunk usually present with subtotal occlusion and electrocardiographic pattern with predominant ST depression (non-ST-elevation myocardial infarction). The cases with complete occlusion frequently present an ST-elevation myocardial infarction pattern, but these patients usually die before reaching the hospital. We present a series of 7 patients with total left main trunk occlusion without collateral circulation showing ST-elevation myocardial infarction pattern. The electrocardiographic pattern is similar to left anterior descending coronary artery proximal occlusion to first septal and first diagonal but without ST elevation in V(1) and aVR because of left circumflex coronary artery compromise. In 4 (60%) of 7 of cases, there is also advanced right bundle-branch block plus superoanterior hemiblock. Despite severe clinical state at entrance (5/7 presented cardiac arrest/cardiogenic shock), 3 patients (43%) survived after percutaneous coronary intervention.

journal_name

J Electrocardiol

journal_title

Journal of electrocardiology

authors

Fiol M,Carrillo A,Rodríguez A,Pascual M,Bethencourt A,Bayés de Luna A

doi

10.1016/j.jelectrocard.2012.05.001

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

487-90

issue

5

eissn

0022-0736

issn

1532-8430

pii

S0022-0736(12)00132-X

journal_volume

45

pub_type

杂志文章

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