The Significance of ST Segment Elevation in Lead aVR in Acute Anterior Myocardial Infarction

Abstract

Background and purposes: lead aVR is an ignored lead in ECG, several studies showed that ST segment elevation in aVR may predict left main stem or 3 vessels disease, and so suggest that ST- elevation in patient with acute anterior myocardial infarction can be predictors for poor prognosis to confirm this; this study was conducted. Patients and Methods:100 patients with acute anterior myocardial infarction were divided into two groups;1st group had ST-segment elevation in lead aVR more than 0.5 mv and other group had no ST-segment elevation in lead aVR. All patients were followed in hospital staying through history, examination ,and investigations for risk factors of coronary vascular disease ,complications, and mortality.Results:ST-segment elevation in lead aVR was an important predictor of occurrence of adverse prognosis, it occurred more in patients with increasing age. Also it occurred more in patients with more risk factors for coronary vascular disease including diabetes mellitus ,hypertension ,smoking, and family history of ischemic heart disease.The study found that the occurrence of complications like shock, post myocardial infarction angina, heart failure, arrythmia were more in patients with ST-segment elevation in lead aVR . It was also found that mortality rate in patients with acute anterior myocardial infarction with ST-segment elevation in lead AVR of more than o.5 mv was higher than patients without ST-segment elevation in lead AVR.Conclusion:The results of this study showed the significance of ST-segment elevation in lead aVR as important predictors of occurrence of complications in patients with acute anterior myocardial infarction and determination which patient require more intensive care and early referral to invasive treatment. Key words: acute anterior myocardial infarction ; lead aVR, electrocardiography