Diagnostic Value of Standard 12 Lead Electrocardiography in Acute RV Myocardial Infarction Research Center of Cardiology- Birjand University of Medical Science

Document Type : Research Paper


1 Associated professor of cardiology, Birjand university of Medical science, Birjand, Iran

2 Associated professor of cardiology, Mashhad University of Medical science Mashhad, Iran

3 Eneral practitioner, Birjand, Iran


Right ventricular infarction (RVMI) is associated with increased morbidity and mortality in patients with acute inferior myocardial infarction (MI). Although, electrocardiography is probably the most useful, simple, and objective tool for the diagnosis of acute MI, there are no well-defined criteria in the standard 12-lead electrocardiogram to properly identify RVMI in patients with acute inferior MI. The aim of this study was to evaluate the value of ST-segment changes in 12-lead in diagnosing RVMI in patients with acute inferior MI.
Materials and Methods
A total of One hundred sixty seven patients, hospitalized with acute inferior MI, were included in this study. The diagnosis of acute inferior MI was based on the clinical history and the appearance of ST-segment elevation (STE) ³1 mm in at least two of the leads (leads II, III, aVF). RVMI was defined by STE³1 mm in lead V4R during the first 12 hours after the beginning of the symptoms. Then the patients were divided into two groups (RVMI + and -) and ST-segment changes were compared between the two groups.
The Ninety patients (51.1%) had RVMI according to lead V4R. ST-segment change ³1mm was seen in I, III, aVL, and in aVF; also ST-segment depression ³2mm in I+aVL and STE³1 mm in lead III greater than lead II (III>II) was significantly different between the two groups. The high sensitivity-specificity was seen in lead I: 86%-72%; lead aVL: 96%-26%; I+aVL: 84%-71%; and III>II: 82%-74%.
More than 1 mm ST-segment depression in lead I, STE in III>II and ST-segment depression³2 mm in I+aVL are possible to identify RVMI in patients with acute inferior MI.


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