Question
Which blood vessel would be involved most commonly in the condition shown by ECG below:
A. Right Coronary Artery.
B. Right Circumflex artery.
C. Left Anterior Descending Artery.
D. Left Coronary Artery.
Show Answer
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Correct Answer » A
Explanation
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Ans: A. Right Coronary Artery
ECG in the image shows: ST segment elevation visible in II, III, aVF (red) and mirror ST depressions in I and aVL leads (blue) suggestive of Inferior STEMI
Inferior STEMI
- Inferior MIs account for 40-50% of all myocardial infarctions..
ECG findings:
- ST elevation in leads II, III and aVF
- Progressive development of Q waves in II, III and aVF
- Reciprocal ST depression in aVL (± lead I).
Blood vessel involvement:
Inferior STEMI can result from occlusion of all three coronary arteries:
- The vast majority (~80%) of inferior STEMIs are due to occlusion of the dominant right coronary artery (RCA).
- Less commonly (around 18% of the time), the culprit vessel is a dominant left circumflex artery (LCx).
- Occasionally, inferior STEMI may result from occlusion of a “type III” or “wraparound” left anterior descending artery (LAD). This produces the unusual pattern of concomitant inferior and anterior ST elevation.
