Electrocardiographic manifestions of proximal left anterior descending artery occlusion

Bernard M. Karnath, John C. Champion, Masood Ahmad

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

We report the case of a 51-year-old woman who presents with a 2-week history of episodes of pressure like chest pain. The initial electrocardiogram was not indicative of myocardial ischemia or infarction and the cardiac enzymes remained normal during the initial hospital day. However, the precordial T waves inverted and progressively deepened on the second hospital day and the patient underwent cardiac catheterization with percutaneous coronary angioplasty and stent placement of the left anterior descending coronary artery with good results. The postprocedure electrocardiogram showed complete resolution of the inverted precordial T waves. The development of new T-wave inversions in the precordial leads of patients presenting with unstable angina is predictive of significant stenosis of the left anterior descending coronary artery. This subgroup of patients has a poor prognosis if medical therapy alone is instituted. Early cardiac catheterization and revascularization is recommended for these patients. Evidence has shown that 75% patients with these electrocardiogram changes who are not revascularized developed extensive anterior wall infarction within a few weeks.

Original languageEnglish (US)
Pages (from-to)173-177
Number of pages5
JournalJournal of Electrocardiology
Volume36
Issue number2
DOIs
StatePublished - Apr 2003

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Keywords

  • Anterior ischemia
  • T-wave inversions
  • Wellen's Syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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