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5 - Significance of reciprocal st segment depression in avl in early diagnosis of inferior myocardial infarction
Çiğdem Yazıcı Ersoy, S. Kerem Okutur, F. Kerim Küçükler, Cemal Bes, Göktuğ Şirin, Murat Kemahlı, Fatih Borlu
Objective: The use of thrombolytic therapy in early stages of myocardial infarction is very crutial for the reduction of the mortality rate. However, in these early stages, in certain cases, the expected ECG changes, can not be shown, so the reciprocal changes in other leads become more significant. In this study, uv examined the diagnostic importance of the reciprocal ST segment depression in aVL in early diagnosis of acute inferior myocardial infarction.
Material and Methods: We have done our study among 58 patients who were admitted to our emergency service within ten hours of the onset of chest pain and were treated for acute inferior myocardial infarction in our coronary intensive care unit, in the first ECG recordings, 30 of these patients showed I mm of ST segment elevation at least two of the classical inferior myocardial infarction leads (Dll, III or aVF) these are compared with 28 patients whose ECG recordings showed abnormal q wave and inverted T wave without ST segment elevation. The recordings of ST segment depressions in Dl, aVL and V 1-6 leads are compared within both groups.
Results: In the first group who had more than I mm of ST segment elevation in inferior leads (Dll, III or aVF) demonsrated the highest percentage (%86.5) of ST segment depression in aVL. On the other side, the second group who had no ST seğmeni elevation showed the highest percentage (%57.I) of ST segment depression in aVL. Although first and second group patients showed the highest percentage of ST segment depression in leads of VS. V4 and V4, V5 respectively, when these findings were compared with those of in aVL it was seen that the findings ofaVL were more valuable.
Conclusion: In the early stages of acute inferior myocardial infarction, the reciprocal changes in aVL are diagnostic as well as ST segment elevations in inferior leads. We came the conclusion that these findings are especially helpful in the early thrombolytic therapy of the patients who display no classical ECG findings.
Keywords: Acute inferior myocardial infarction, Reciprocal ST segment depression, Early diagnosis.
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