Image Based Question-67184

Blockage in which blood vessel would have resulted in the condition shown by ECG below:

A. Left Anterior Descending Artery.

B. Left Coronary Artery.

C. Right Coronary Artery.

D. Right Circumflex artery.

Correct Answer » A Explanation

Ans: A. Left Anterior Descending Artery

ECG in the image shows:

Hyperacute Anteroseptal STEMI

•  ST elevation is maximal in the anteroseptal leads (V1-4).
• Q waves are present in the septal leads (V1-2).
• There is also some subtle STE in I, aVL and V5, with reciprocal ST depression in lead III.
• There are hyperacute (peaked ) T waves in V2-4.

Anterior STEMI

• It results from occlusion of the left anterior descending artery (LAD).
• Anterior myocardial infarction carries the worst prognosis of all infarct locations, mostly due to larger infarct size.

ECG findings:

• ST segment elevation with Q wave formation in the precordial leads (V1-6) ± the high lateral leads (I and aVL).
• Reciprocal ST depression in the inferior leads (mainly III and aVF).

The different infarct patterns are named according to the leads with maximal ST elevation:

• Septal = V1-2
• Anterior = V2-5
• Anteroseptal = V1-4
• Anterolateral = V3-6, I + aVL
• Extensive anterior / anterolateral = V1-6, I + aVL