Determination of the infarct related artery and minoca frequency in St elevated acute coronary syndrome by electrocardiography

Objective: The location of obstruction in myocardial infarction with ST elevated acute coronary syndrome is closely related to the area of myocardial necrosis and prognosis. Therefore, many studies using ST segment elevation or reciprocal ST depression have been performed to determine the location of the infarct-related lesion. The rates of predicting lesion location in these studies vary widely. The aim of our study is to determine the location of the lesion and also the frequency of patients without severe coronary stenosis by using electrocardiography in ST elevated acute coronary syndrome. Material and Methods: In our study, patients admitted to our hospital with a diagnosis of myocardial infarction with acute ST elevation for 1 year were retrospectively screened. Patients were divided into 2 groups according to ST elevation type: Patients with acute ST elevated anterior myocardial infarction (n = 47), patients with acute ST elevated inferior myocardial infarction (n = 82). Coronary angiography findings were analyzed and compared between both groups. Results: In our study, 72% of patients with inferior myocardial infarction were in the right coronary artery, 25.6% of them were in the left circumflex artery, 35.6% of patients with anterior myocardial infarction before the first septal branch (proximal), and 64.4% of the first septal branch later (distally) the (culprit) lesion responsible for infarction was found. Although 3.7% of the patients had ST elevation, no obstructive coronary artery disease (MINOCA) was detected. Among the criteria of electrocardiography, the presence of > 2 mm ST depression in aVL in the diagnosis of right coronary artery occlusion, if R / S> 1 in aVL, in the left circumflex artery occlusion,> 2.5 mm ST elevation in V1 and ST elevation in aVR were more susceptible to proximal occlusion of the left anterior descending artery, and ST depression in D2, D3 and aVF were more susceptible to distal occlusion. Conclusion: Baseline electrocardiographic findings of patients with ST-elevated acute coronary syndrome can provide important information about the culprit lesion and can speed up clinical decision making and also direct the reperfusion therapy. Keywords: ST Elevation, Myocardial İnfarction, MINOCA, Electrocardiography