Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2019;72:248 - Vol. 72 Num.03 DOI: 10.1016/j.rec.2018.04.033

Response to ECG, February 2019

Alejandro Cruz-Utrilla a,, Hernán Mejía-Rentería a, Alejandro Travieso-González a

a Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain

Refers to

Free articleECG, February 2019
Alejandro Cruz-Utrilla, Hernán Mejía-Rentería, Alejandro Travieso-González
Rev Esp Cardiol. 2019;72:165
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Article

The electrocardiogram (ECG) (Figure 1), with ST depression and hyperacute T wave in precordial leads, allows the culprit vessel to be located (response 2, incorrect). As described by de Winter et al.1 in 2008, the ECG indicates acute proximal left anterior descending artery occlusion, as shown in the diagnostic coronary angiogram (Figure 2A, arrow), and so the correct response is answer 4. The ECG does not indicate a subocclusive lesion in the left main coronary artery (response 1, incorrect). In this case, the ECG would usually show diffuse ST depression and ST elevation in aVR.2 Likewise, this is not posterior ST-elevation acute coronary syndrome (response 3, incorrect). If it were, the ECG would possibly show ST elevation in the leads corresponding to the inferior face.

Figure 1.

Figure 2.

Corresponding author: acruzutrilla@gmail.com

Bibliography

1. De Winter RJ, Verouden NJ, Wellens HJ, Wilde AA. Interventional Cardiology Group of the Academic Medical Center. A new ECG sign of proximal LAD occlusion. N Engl J Med. 2008;359:2071-3.
2. Kurisu S, Inoue I, Kawagoe T, et al. Electrocardiographic features in patients with acute myocardial infarction associated with left main coronary artery occlusion. Heart. 2004;90:1059-60.

1885-5857/© 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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