Key result
ECG ST-segment changes identify culprit arteries in acute MI, though multivessel disease limits accuracy.
Why the study?
Localization of the occluded vessel in acute myocardial infarction is important for guiding revascularization, assessing lesion severity, correlating with echocardiographic abnormalities, and differentiating recent from old occlusions.
12-lead ECG remains a fundamental clinical tool for identifying the culprit artery in acute myocardial infarction, which is critical for guiding reperfusion strategies.
ECG aids culprit artery localization in AMI despite limitations; leaves open validation of adjunctive tools in multivessel disease.
This is a review of features in ECG to diagnose the culprit artery responsible for the infarction. Localization of the occluded vessel in acute myocardial infarction is important for many reasons: to know which artery is to dilate and stent; to assess the severity of the lesion; to compare with the echocardiographic area with hypokinesia or akinesia and to differentiate the recent from the old occluded vessel. The ST-segment changes in 12-lead ECG form the basis of diagnosis, management, and prognosis.
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Rafla et al. (2020) conducted a review in Acute myocardial infarction. 12-lead electrocardiography was evaluated. ST-segment changes on a 12-lead ECG can help localize the occluded culprit artery in acute myocardial infarction, though accuracy is limited by multivessel disease and previous infarcts.
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