September 3, 2014 by dailybolusoflr
45 yo M presents with chest pain with the following EKG:
|Alley, P. Another Widow Maker. Life in the Fast Lane. http://lifeinthefastlane.com/another-widow-maker/.|
Question of the day: does ST elevation in lead AVR have any significance?
In a patient with symptoms of acute coronary syndrome, ST elevation in lead AVR could represent one of the following:
1) left main coronary artery occlusion
2) proximal left anterior descending artery occlusion
3) multivessel disease
Studies have also show that findings in lead AVR can predict patient outcomes:
- AVR ST segment elevation was the strongest predictor of adverse events in 90 days in NSTEMI patients
- AVR ST segment elevation was associated with higher rates of in hospital death, recurrent ischemia and heart failure
- Kurz MC, Mattu, A, Brady WJ. Chapter 78 – Acute Coronary Syndrome. Rosen’s Emergency Medicine – Concepts and Clinical Practice, 8th edition. Saunders, an imprint of Elsevier Inc; 2014.
- George A, Arumugham PS, Figueredo VM. AVR – the forgotten lead. Exp Clin Cardiol 2010;15(2):e36-e44.
- Alley, P. Another Widow Maker. Life in the Fast Lane. http://lifeinthefastlane.com/another-widow-maker/.