Ecg contest
Response to ECG, September 2017

Respuesta al ECG de septiembre de 2017

Pablo Robles VelascoIsabel Monedero SánchezRoberto del Castillo Medina

ECG, September 2017

Rev Esp Cardiol. 2017;70:77310.1016/j.rec.2017.02.016

Pablo Robles Velasco, Isabel Monedero Sánchez, Roberto del Castillo Medina

https://doi.org/10.1016/j.rec.2017.02.015

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3365 Total HTML

Year/month	Html	Pdf	Total
2024 October	1	0	1
2024 September	57	23	80
2024 August	53	39	92
2024 July	30	19	49
2024 June	33	10	43
2024 May	37	17	54
2024 April	31	43	74
2024 March	37	22	59
2024 February	22	25	47
2024 January	24	17	41
2023 December	24	29	53
2023 November	36	30	66
2023 October	44	54	98
2023 September	18	14	32
2023 August	15	11	26
2023 July	28	18	46
2023 June	38	28	66
2023 May	31	16	47
2023 April	15	15	30
2023 March	9	9	18
2023 February	28	6	34
2023 January	14	12	26
2022 December	15	10	25
2022 November	26	18	44
2022 October	20	25	45
2022 September	32	16	48
2022 August	46	37	83
2022 July	24	23	47
2022 June	22	17	39
2022 May	22	22	44
2022 April	39	16	55
2022 March	25	29	54
2022 February	23	19	42
2022 January	19	22	41
2021 December	26	30	56
2021 November	30	25	55
2021 October	76	25	101
2021 September	52	17	69
2021 August	53	29	82
2021 July	32	22	54
2021 June	19	12	31
2021 May	13	13	26
2021 April	39	33	72
2021 March	44	15	59
2021 February	33	12	45
2021 January	27	6	33
2020 December	41	10	51
2020 November	15	8	23
2020 October	28	11	39
2020 September	57	8	65
2020 August	71	7	78
2020 July	54	9	63
2020 June	12	14	26
2020 May	42	9	51
2020 April	41	12	53
2020 March	25	15	40
2020 February	14	7	21
2020 January	25	12	37
2019 December	25	15	40
2019 November	18	8	26
2019 October	5	3	8
2019 September	17	10	27
2019 August	10	8	18
2019 July	41	56	97
2019 June	34	21	55
2019 May	28	17	45
2019 April	41	17	58
2019 March	51	17	68
2019 February	70	17	87
2019 January	59	11	70
2018 December	85	21	106
2018 November	52	9	61
2018 October	70	10	80
2018 September	37	15	52
2018 August	39	12	51
2018 July	90	12	102
2018 June	92	13	105
2018 May	71	21	92
2018 April	84	14	98
2018 March	81	6	87
2018 February	70	9	79
2018 January	61	11	72
2017 December	30	6	36
2017 November	36	10	46
2017 October	209	36	245
2017 September	52	17	69

Coronary angiography showed occlusion of the right coronary artery (RCA) that implicated the origin of a right ventricular branch (Figure A, arrow). The artery was opened and the electrocardiogram (ECG) showed correction of the ST abnormalities in the precordial leads (Figure B). Occlusion of the left coronary artery leads to an extensive subendocardial lesion with ST elevation in aVR > V1. Simultaneous occlusion of the proximal left anterior descending artery would lead to generalized ST elevation in left precordial leads (answers 1 and 3, incorrect). The ECG is characteristic of acute inferior myocardial infarction with RCA and right ventricular involvement.1 Simultaneous ST elevation in leads V1-V3 suggests a differential diagnosis with occlusion of the distal left anterior descending artery where it passes over the cardiac apex. ST elevation in V1 > V2 > V3 along with ECG showing RCA involvement differentiates the lesion from simultaneous occlusion of a right ventricular branch2 (answer 2 incorrect; the correct answer is answer 4).

Figure

(0.3MB).

References

[1]

P. Robles, J.J. Jimenez.

Working in reverse.

Am J Med., (2006), 119 pp. 1043-1044

http://dx.doi.org/10.1016/j.amjmed.2006.10.001 | Medline

[2]

B.S.N. Alzand, A.P.M. Gorgels.

Combined anterior and inferior ST-segment elevation Electrocardiographic differentiation between right coronary artery occlusion with predominant right ventricular infarction and distal left anterior descending branch occlusion.

J Electrocardiol., (2011), 44 pp. 383-388

http://dx.doi.org/10.1016/j.jelectrocard.2011.02.002 | Medline

https://doi.org/10.1016/j.rec.2017.02.015

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1494 Total PDF

3365 Total HTML

Year/month	Html	Pdf	Total
2024 October	1	0	1
2024 September	57	23	80
2024 August	53	39	92
2024 July	30	19	49
2024 June	33	10	43
2024 May	37	17	54
2024 April	31	43	74
2024 March	37	22	59
2024 February	22	25	47
2024 January	24	17	41
2023 December	24	29	53
2023 November	36	30	66
2023 October	44	54	98
2023 September	18	14	32
2023 August	15	11	26
2023 July	28	18	46
2023 June	38	28	66
2023 May	31	16	47
2023 April	15	15	30
2023 March	9	9	18
2023 February	28	6	34
2023 January	14	12	26
2022 December	15	10	25
2022 November	26	18	44
2022 October	20	25	45
2022 September	32	16	48
2022 August	46	37	83
2022 July	24	23	47
2022 June	22	17	39
2022 May	22	22	44
2022 April	39	16	55
2022 March	25	29	54
2022 February	23	19	42
2022 January	19	22	41
2021 December	26	30	56
2021 November	30	25	55
2021 October	76	25	101
2021 September	52	17	69
2021 August	53	29	82
2021 July	32	22	54
2021 June	19	12	31
2021 May	13	13	26
2021 April	39	33	72
2021 March	44	15	59
2021 February	33	12	45
2021 January	27	6	33
2020 December	41	10	51
2020 November	15	8	23
2020 October	28	11	39
2020 September	57	8	65
2020 August	71	7	78
2020 July	54	9	63
2020 June	12	14	26
2020 May	42	9	51
2020 April	41	12	53
2020 March	25	15	40
2020 February	14	7	21
2020 January	25	12	37
2019 December	25	15	40
2019 November	18	8	26
2019 October	5	3	8
2019 September	17	10	27
2019 August	10	8	18
2019 July	41	56	97
2019 June	34	21	55
2019 May	28	17	45
2019 April	41	17	58
2019 March	51	17	68
2019 February	70	17	87
2019 January	59	11	70
2018 December	85	21	106
2018 November	52	9	61
2018 October	70	10	80
2018 September	37	15	52
2018 August	39	12	51
2018 July	90	12	102
2018 June	92	13	105
2018 May	71	21	92
2018 April	84	14	98
2018 March	81	6	87
2018 February	70	9	79
2018 January	61	11	72
2017 December	30	6	36
2017 November	36	10	46
2017 October	209	36	245
2017 September	52	17	69

Ecg contest Response to ECG, September 2017

Respuesta al ECG de septiembre de 2017

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Ecg contest
Response to ECG, September 2017