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Inferior MI: Difference between revisions
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{{Chapter|Myocardial Infarction}} | {{Chapter|Myocardial Infarction}} | ||
'''ST elevation in II, III and aVF''' | '''ST elevation in II, III and aVF''' | ||
[[image:V4R_occlusion.svg|thumb|ST elevation or depression in V4R can help in differentiating a RCA from a RCX occlusion.]] | |||
This part of the heart muscle lies on the diaphragm and is supplied of blood bij the right coronary artery (RCA) in 80% of patients. In the remaing 20% the inferior wall is supplied by the ramus circumflexus(RCX). | This part of the heart muscle lies on the diaphragm and is supplied of blood bij the right coronary artery (RCA) in 80% of patients. In the remaing 20% the inferior wall is supplied by the ramus circumflexus(RCX). | ||
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An occlusion of the RCA can be distinguished of a RCX occulusion on the ECG:<cite>Zimetbaum</cite> | An occlusion of the RCA can be distinguished of a RCX occulusion on the ECG:<cite>Zimetbaum</cite> | ||
;Distal RCA occlusion (sens 90%, spec 71%) | ;Distal RCA occlusion (sens 90%, spec 71%) | ||
*ST segment elevation in III higher than ST segment elevation in II and | *ST segment elevation in III higher than ST segment elevation in II ("the highest elevation points at the culprit")and | ||
*ST segment depression in I, AVL, or both (>1 mm) | *ST segment depression in I, AVL, or both (>1 mm) | ||
;Proximal RCA occlusion (sens 79%, spec 100%) | ;Proximal RCA occlusion (sens 79%, spec 100%) | ||