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Discourses on EKG

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  1. Discourseson EKG Ali Kazemi Saeid

  2. Determination the site of occlusion in the coronary artery

  3. LCX RCA

  4. Proximal of RCA

  5. Distal of RCA

  6. LCX

  7. LAD Occlusion • Proximal to first septal branch and first diagonal • Distal to first septal, proximal to first diagonal • Distal to first diagonal, proximal to first septal • Distal LAD

  8. Proximal to first septal and first diagonal

  9. ST deviation vector points to the base of the heart, causing: • ST elevation in leads aVR and aVL • ST depression in leads II, III, aVF • ST elevation in lead V1(>2mm) and leads V2 to V4 • ST isoelectric or depressed in leads V5 and V6 Note: Acquired intra-Hissal or RBBB may occur.

  10. Distal to first septal, proximal to first diagonal

  11. ST deviation vector points to lead aVL, causing: • ST elevation in leads I and aVL • ST depression in lead III (lead II is isoelectric) • ST elevation in leads V2 to V6 but not in lead V1

  12. Distal to first diagonal , proximal to first septal

  13. Distal LAD occlusion

  14. ST deviation vector points apically toward lead III, causing: • ST depression aVR • ST elevation in inferior leads, highest in II • ST elevation in leads V3 to V6

  15. Left main occlusion

  16. ST deviation vector points to lead aVR • ST elevation in lead aVR • ST elevation in lead V1( lower than that of lead aVR) • ST depression in lead II,aVF (basal ischemia) • ST depression in the precordial leads to the left of V2 (posterior ischemia)

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