Angiographic findings in patients with ST segment elevation in lead AVR

Abstract

Acute coronary syndrome (ACS) refers to a group of conditions due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. The most common symptom is chest pain, often radiating to the left arm or angle of the jaw, pressure-like in character, and associated with nausea and sweating. Acute coronary syndrome usually occurs as a result of one of three problems: ST elevation myocardial infarction (STEMI, 30%), non ST elevation myocardial infarction (NSTEMI, 25%), or unstable angina(38%) (Amsterdam, 2014). Lead aVR, an augmented unipolar limb lead, was constructed to obtain specific information from the right upper portion of the heart, including the outflow tract of the right ventricle and the basal portion of the inter-ventricular septum. However, lead aVR has been long neglected until recent years. This is thought to be because most cardiologists have considered that the tracing of lead aVR merely reflects reciprocal information from the lateral limb and precordial leads. However, in the last decade, evidence indicating the importance of lead aVR in the field of acute coronary syndrome (ACS) has been accumulating (Taglieri,2011).