The Significance of the Precordial ST: segment Depression in Acute (V1- V3) Inferior Myocardial Infarction

Lew, Hyae Young; Yun, Yong Sun; Kang, Heung Sun; Choue, Chung Whee; Kim, Kwon Sam; Kim, Myung Shick; Song, Jung Sang; Bae, Jong Wha

Abstract

BACKGROUND: Reciprocal ST-segment depression in precordial leads is a common finding in acute inferior myocardial infarction. The responsible mechanism and the significance of this finding, however, are still controversial.
METHODS
From January 1991 to December 1994, 38 patients with acute inferior myocardial infarction were treated at the Department of Internal Medicine in Kyung Hee University Hospital. Clinical characteristics, serial electrocardiograms, and angiographic findings of coronary artery and left ventriculography, echocardiography were reviewed. Reciprocal ST-segment depression was defined as ST-segment depression>or=1.0mm in two or more adjacent precordial leads(V1-V3) in patients with acute inferior myocardial infarction showing ST-segment elevation in II, III, aVF. Coronary angiography and echocardiography were performed within 24 hours from admission. In this study, angiographic distribution score was used to define the perfusion territory causing inferior ischemia.
RESULTS
1) The summation of ST-segment elevation in II, III, aVF leads was significantly more higher in group H than group A (P<0.05). 2) However, the angiographic distribution score, peak CK levels, in-hospital complications and ejection fraction showed no difference between two groups (P>0.05). 3) There were no evidence of anterior wall motion abnormality in two groups.
CONCLUSIONS
Our results suggest that the S'I'- segment depression on the precordial leads in acute myocardial infarction can be explained mainly by benign reciprocal electrical change.