Is ST elevation in aVR a sure sign of left main coronary artery stenosis?

被引:3
作者
Morris, Niall [1 ,2 ]
Body, Richard [1 ,2 ]
机构
[1] Manchester Royal Infirm, Manchester, Lancs, England
[2] Univ Manchester, Manchester, Lancs, England
关键词
ACUTE MYOCARDIAL-INFARCTION; SEGMENT ELEVATION; LEAD AVR; DISEASE;
D O I
10.1136/emermed-2015-205558.2
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
A shortcut review was carried out to establish whether ST elevation in aVR accurately identifies acute myocardial infarction caused by left main coronary artery stenosis. 141 unique papers were found in Medline, EMBASE, Cochrane Database of Systematic Reviews, ACP Journal Club and the Database of Abstracts of Reviews of Effects using the reported searches. Of these, 12 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that ST elevation in aVR can identify high-risk patients for early intensive investigation, particularly when found alongside widespread ST depression. It has insufficient utility to identify patients who require immediate revascularisation.
引用
收藏
页码:77 / 80
页数:4
相关论文
共 12 条
[1]   Prognostic value of lead aVR in patients with a first non-ST-segment elevation acute myocardial infarction [J].
Barrabés, JA ;
Figueras, J ;
Moure, C ;
Cortadellas, J ;
Soler-Soler, J .
CIRCULATION, 2003, 108 (07) :814-819
[2]   Improved detection of acute myocardial infarction in patients with chest pain and significant left main stem coronary stenosis [J].
Daly, M. J. ;
Adgey, J. A. ;
Harbinson, M. T. .
QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 2012, 105 (02) :127-135
[3]  
Hengrussamee Kriengkrai, 2005, Journal of the Medical Association of Thailand, V88, P1382
[4]   Clinical features of emergency electrocardiography in patients with acute myocardial infarction caused by left main trunk obstruction [J].
Hirano, T ;
Tsuchiya, K ;
Nishigaki, K ;
Sou, K ;
Kubota, T ;
Ojio, S ;
Kawasaki, M ;
Minatoguchi, S ;
Fujiwara, H ;
Ueno, K ;
Hosokawa, H ;
Morita, N ;
Nagano, T ;
Suzuki, T ;
Watanabe, S .
CIRCULATION JOURNAL, 2006, 70 (05) :525-529
[5]   Diffuse ST depression with ST elevation in aVR: Is this pattern specific for global ischemia due to left main coronary artery disease? [J].
Knotts, Robert J. ;
Wilson, James M. ;
Kim, Edward ;
Huang, Henry D. ;
Birnbaum, Yochai .
JOURNAL OF ELECTROCARDIOLOGY, 2013, 46 (03) :240-248
[6]   Predictors of left main or three-vessel disease in patients who have acute coronary syndromes with non-ST-segment elevation [J].
Kosuge, M ;
Kimura, K ;
Ishikawa, T ;
Ebina, T ;
Shimizu, T ;
Hibi, K ;
Toda, N ;
Tahara, Y ;
Tsukahara, K ;
Kanna, M ;
Okuda, J ;
Nozawa, N ;
Ozaki, H ;
Yano, H ;
Umemura, S .
AMERICAN JOURNAL OF CARDIOLOGY, 2005, 95 (11) :1366-1369
[7]   An Early and Simple Predictor of Severe Left Main and/or Three-Vessel Disease in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome [J].
Kosuge, Masami ;
Ebina, Toshiaki ;
Hibi, Kiyoshi ;
Morita, Satoshi ;
Endo, Mitsuaki ;
Maejima, Nobuhiki ;
Iwahashi, Noriaki ;
Okada, Kozo ;
Ishikawa, Toshiyuki ;
Umemura, Satoshi ;
Kimura, Kazuo .
AMERICAN JOURNAL OF CARDIOLOGY, 2011, 107 (04) :495-500
[8]  
Kühl JT, 2009, ANN NONINVAS ELECTRO, V14, P219, DOI 10.1111/j.1542-474X.2009.00300.x
[9]  
Nough H, 2012, Rom J Intern Med, V50, P159
[10]  
Rostoff Pawel, 2005, Kardiol Pol, V62, P128