CORONARY ARTERY DISEASE;

ACUTE INFERIOR WALL MYOCARDIAL INFARCTION WITH ST SEGMENT DEPRESSION IN ANTERIOR CHEST LEADS

Abstract

Objectives: To determine the frequency of multivessel coronary artery disease
(CAD) in patients suffering from inferior wall acute myocardial infarction (AMI) having ST
segment depression in anterior chest leads. Study Design: Cross Sectional Survey. Setting:
Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad. Period: December
2013 to June 2014. Materials and Methods: After fulfilling the inclusion criteria, 120 patients
with acute inferior wall MI were studied. Patients were divided in two groups. Group I included
patients with ST segments depression in leads V1-V3 and Group II with ST segment depression
in leads V4-V6. Age of patients ranged from 25 to 70 years. Results: The mean age was
52.5±10.5 years. As regards sex distribution, 100 patients were male, 54 in Group I and 46
in Group II. There were 20 female patients, 11 in Group I and 9 in Group II. Thirty six (30%)
patients were diabetic, 22(33.8%) in Group I and 14(25.5%) in Group II. Forty five (37.5%)
patients were hypertensive. Fifty two (43.3%) patients were smokers. Forty three (35.8%)
patients had family history of ischemic heart disease, 25(38.5%) in Group I and 18(32.7%) in
Group II. Thirty five (29.2%) had hyperlipidemia, 20 (30.8%) in Group I and 15(29.2%) in Group
II. All patients underwent coronary angiogram. Thirty eight (31.7%) patients had single vessel
disease, 29(44.6%) patients in Group I and 9(16.4%) in Group II. Forty three (35.8%) patients
had double vessel coronary artery disease, 23 patients (35.4%) in Group I and 20(36.4%) in
Group II. Thirty nine (32.5%) had three vessel coronary artery disease, 13 (20%) in Group I and
26 (47.3%) in Group II. Eighty three (69.2%) patients had multivessel coronary artery disease
37(56.8%) in Group I and 46 (83.6%) in Group II (p value <0.002). Conclusion: The presence of
precordial ST depression during acute inferior wall myocardial correlates well with multivessel
CAD. Precordial ST-segment depression in acute inferior wall MI is related to anterior injury due
to LAD stenosis and these patients tend to have more severe CAD.