ECG Guru - Instructor Resources - Left main coronary artery obstruction https://www.ecgguru.com/ecg/left-main-coronary-artery-obstruction en Left Main Coronary Artery Obstruction https://www.ecgguru.com/ecg/left-main-coronary-artery-obstruction-0 <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/left-main-coronary-artery-obstruction-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/left_main3.jpg" width="2255" height="765" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p class="MsoNormal"><span style="font-size: 10.0pt; line-height: 107%;">Today’s ECG of the WEEK comes from <span style="color: #c00000;">Sebastian Garay</span>, Paramedic.&nbsp; He presented it on his excellent website <a href="http://www.cardiocareconcepts.com/Case-Studies.html">CardioCareConcepts.com</a>, and was kind enough to share it with the ECG Guru.&nbsp; It is a great example of LEFT MAIN CORONARY ARTERY lesion with ST elevation in aVR and V1.</span></p><p class="MsoNormal"><span style="font-size: 10.0pt; line-height: 107%;">The patient was a 68 year old man who presented with a sudden onset of chest pain, followed by cardiac arrest.&nbsp; He was revived by the use of an automatic external defibrillator (AED).&nbsp; The initial 12-Lead ECG shows atrial fibrillation with a rapid response of 102 bpm.&nbsp; There are prominent ST ELEVATIONS in aVR and somewhat more subtle STEs in V1.&nbsp; These leads reflect the base of the septum, which is the area perfused by the proximal left coronary artery.&nbsp; A lesion in this area is sometimes in the LEFT MAIN coronary artery, or both the proximal LCA and the circumflex.&nbsp; Both of these types of lesions carry a very high mortality rate.</span></p><p class="MsoNormal"><span style="font-size: 10.0pt; line-height: 107%;">The widespread ST depressions reflect the injury current, which is being directed upward and toward the patient’s right shoulder, causing a reciprocal depression in all leads except aVR, V1 and Lead III.</span></p><p class="MsoNormal"><span style="font-size: 10.0pt; line-height: 107%;">This patient arrived in the Emergency Dept. in grave condition and was taken to the cath lab, where an occlusive lesion was found in the LEFT MAIN coronary artery.&nbsp; He later died from this severe injury.</span></p><p class="MsoNormal"><span style="font-size: 10.0pt; line-height: 107%;">We recommend further reading on this topic, as there has been a large body of research on ECG findings of ST elevation in aVR.&nbsp; Here are some links of interest:</span></p><p>&nbsp;</p><p class="MsoNormal"><span style="font-size: 10.0pt; line-height: 107%;"><a href="http://www.hqmeded-ecg.blogspot.com/2014/08/the-difference-between-left-main.html">Dr. Smith’s Blog</a>; &nbsp;&nbsp;<a href="http://content.onlinejacc.org/article.aspx?articleid=1127535">JACC Online</a>; <a href="http://www.sciencedirect.com/science/article/pii/S0735109701015637">ScienceDirect.com</a>.</span></p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/571/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Left Main Coronary Artery Obstruction 1/5</option><option value="40">Give Left Main Coronary Artery Obstruction 2/5</option><option value="60">Give Left Main Coronary Artery Obstruction 3/5</option><option value="80" selected="selected">Give Left Main Coronary Artery Obstruction 4/5</option><option value="100">Give Left Main Coronary Artery Obstruction 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.8</span></span> <span class="total-votes">(<span >5</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-tKVH_5qpxcTHdmlVClua17eA9I3XVolm_cXr1OL9pNw" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/stemi" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">STEMI</a></div><div class="field-item odd"><a href="/ecg/left-main-coronary-artery-obstruction" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Left main coronary artery obstruction</a></div><div class="field-item even"><a href="/ecg/proximal-lca" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Proximal LCA</a></div><div class="field-item odd"><a href="/ecg/anterior-wall-mi-5" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Anterior wall M.I.</a></div><div class="field-item even"><a href="/ecg/st-elevation" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ST elevation</a></div><div class="field-item odd"><a href="/ecg/st-elevation-avr" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ST elevation in aVR</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fleft-main-coronary-artery-obstruction-0&amp;title=Left%20Main%20Coronary%20Artery%20Obstruction"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Mon, 11 May 2015 07:15:25 +0000 Dawn 638 at https://www.ecgguru.com https://www.ecgguru.com/ecg/left-main-coronary-artery-obstruction-0#comments