ST-Segment Depression in aVR: An Overlooked Finding Associated With an Anterior Infarction
Edwin A Rodríguez1, Macarena Rosati1, José M Aladio1
1University of Buenos Aires, Buenos Aires, Argentina. Cardiovascular Intensive Care Unit at José de San Martín Hospital, Buenos Aires, Argentina.
JACC. Case Reports
|February 20, 2025
Summary
ST-segment depression in the aVR lead, though rarely reported, can indicate both ischemic and nonischemic conditions. This finding is crucial for diagnosing myocardial infarction and other cardiac issues.
Area of Science:
- Cardiology
- Electrocardiography
Background:
- ST-segment depression in the aVR lead is an underrecognized electrocardiographic finding.
- It is associated with various ischemic and nonischemic cardiac conditions.
Observation:
- A 42-year-old male presented with an anterior ST-segment elevation myocardial infarction.
- His electrocardiogram showed ST-segment elevation in multiple leads (DI, aVL, V1-V6) and ST-segment depression in the aVR lead.
Findings:
- The presence of ST-segment depression in aVR, alongside ST elevation in other leads, occurred in the context of acute myocardial infarction due to left anterior descending artery subocclusion.
- This case highlights that ST-segment depression in aVR is not exclusively linked to specific conditions and can appear in diverse clinical scenarios.
Implications:
- ST-segment depression in aVR warrants careful consideration in the interpretation of electrocardiograms.
- Recognizing this finding can aid in the differential diagnosis of both ischemic and nonischemic cardiac presentations.
- Further research is needed to fully elucidate the diagnostic and prognostic significance of ST-segment depression in aVR.
