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Revista mexicana de cardiología
versão impressa ISSN 0188-2198
Resumo
FELIX-BULMAN, Jorge Andrés; AMADOR-MENA, José Eduardo e MACIAS-GARRIDO, Enrico. Electrocardiographic analysis of V1-V4 leads in infarction by proximal right coronary artery occlusion. Rev. Mex. Cardiol [online]. 2017, vol.28, n.4, pp.200-205. ISSN 0188-2198.
Introduction:
In some cases, ST segment elevation in right precordial leads in conjunction with inferior leads can be originated by an obstruction of the right coronary artery in its proximal portion, generating an inferior myocardial infarction which involves the right ventricle.
Case presentation:
We present the case of a 57-year-old male, which presents symptoms of acute coronary syndrome. The electrocardiogram shows subepicardial injury in anteroseptal leads (V1-V3) and elevation of ST segment in inferior leads (DIII, AVF). A coronariography is performed finding a complete obstruction of right coronary artery in the proximal portion, left coronary artery without lesions.
Analysis:
In right ventricular infarction or anteroseptal infarction, the ST segment vector always has a posterior- anterior direction in horizontal plane, the direction of this vector will produce an elevation of ST segment in leads V1 to V3 (even V4).
Conclusion:
It is necessary to do a correct analysis of the electrocardiogram for understanding the mentioned changes and to not assume that the electrocardiographic manifestations are a consequence of multivessel disease.
Palavras-chave : Infarct; electrocardiogram; elevation; vector.