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ECG changes in myocardial ischemia

ECG changes in myocardial ischemia 1) leads V1, V2 a) involved arteries - left circumflex - left anterior descending, septal branch b) tissue injury - septum - His bundle & bundle branches 3) complications: His bundle & bundle branch block 2) leads V3, V4 a) involved arteries - left circumflex - left anterior descending, diagonal branch b) tissue injury: anterior wall of left ventricle c) complications - left ventricular dysfunction - congestive heart failure (CHF) - bundle branch block - complete heart block - premature ventricular contractions (PVC's) 3) leads V5, V6, I, aVL a) involved arteries: - left circumflex artery, circumflex branch b) tissue injury: lateral wall of left ventricle c) complications - left ventricular dysfunction - AV nodal block 4) leads II, III, aVF a) involved arteries - right coronary artery (RCA), posterior descending branch b) tissue injury - inferior wall of left ventricle - posterior wall of left ventricle c) complications: - hypotension - sensitivity to nitroglycerin & morphine d) shark fin pattern (massive posterior-inferior wall STEMI) [5] - junctional rhythm - reciprocal depression in leads I, aVL, V2-4 5) leads II, III, aVF, V4 a) involved arteries - right coronary artery (RCA), proximal branch b) tissue injury - right ventricle - inferior wall of left ventricle - posterior wall of left ventricle c) complications: - hypotension - AV nodal block - atrial fibrillation/flutter - premature atrial contractions (PAC's) 6) leads V1-V3, dominant R waves & ST segment depression a) involved arteries - left circumflex artery, circumflex branch - right coronary artery (RCA), posterior descending branch b) tissue injury: posterior wall of left ventricle c) complications: left ventricular dysfunction

Related

electrocardiogram (ECG, EKG) myocardial ischemia

General

analysis

References

  1. Advanced Cardiac Life Support, American Heart Association, 1997-99
  2. ACLS - The Reference Texbook ACLS: Principles & Practice, Cummins RO et al (eds), American Heart Association, 2003 ISBN 0-87493-341-2
  3. Zimetbaum PJ, Josephson ME. Use of the electrocardiogram in acute myocardial infarction. N Engl J Med 2003 Mar 7; 348:933 PMID: 12621138
  4. Zhao YT, Huang YS. ECG Pattern Associated with Left Anterior Descending Coronary Artery Occlusion. N Engl J Med 2018; 378:e22. April 19, 2018 PMID: 29669230 http://www.nejm.org/doi/full/10.1056/NEJMicm1714059
  5. Dr. Smith's ECG Blog. June 11, 2018 http://hqmeded-ecg.blogspot.com/2018/06/shark-fin-deadly-ecg-sign-that-you-must.html