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Electrocardiographic changes in patients with acute myocardial infarction caused by left main trunk occlusion

Cinzia D'Angelo1, Silvia Zagnoni, Pamela Gallo

  • 1Department of Cardiology, Maggiore Hospital, Bologna, Italy.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|June 12, 2018
PubMed

Insights

Electrocardiogram (ECG) patterns like ST-segment elevation in lead aVR or a left anterior descending (LAD) pattern can indicate left main trunk (LMT) disease. Other key indicators include left axis deviation and prolonged QTc intervals.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Electrocardiography

Background:

  • Left main trunk (LMT) occlusion is a rare but critical angiographic finding.
  • Investigating the specific electrocardiogram (ECG) patterns associated with LMT disease is essential for early diagnosis.

Purpose of the Study:

  • To determine the characteristic ECG findings in patients with angiographically confirmed left main trunk (LMT) occlusion.
  • To correlate ECG patterns with clinical outcomes in LMT disease.

Main Methods:

  • Analysis of 48 patients with total or subtotal LMT occlusion.
  • Evaluation of ECG parameters including axis deviation, QRS width, QTc interval, and ST-segment changes.
  • Correlation of ECG findings with clinical presentation and in-hospital mortality.

Main Results:

  • Significant left axis deviation (54%) and intraventricular conduction delay (67%) were common.
  • ST-segment elevation in lead aVR (67%) and LAD-type patterns (35%) were frequently observed.
  • In-hospital mortality was high at 38%, with cardiogenic shock, left axis deviation, and prolonged QTc/QRS associated with adverse outcomes.

Conclusions:

  • Specific ECG patterns, including ST-elevation in aVR and LAD-type ST changes, are associated with LMT disease.
  • Left axis deviation, prolonged QTc, and widened QRS are significant indicators in LMT occlusion.
  • Prompt recognition of these ECG findings is crucial for managing LMT disease and improving patient outcomes.
Abstract

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