AVR ST elevation
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Overview
- AVR elevation is commonly thought of as a sign of Left Main Coronary Artery (LMCA) occlusion. However, STE 0.5mm or greater in lead aVR to be present in 78% of patients with and 14% of patients without LMCA stenosis.[1]
- Use > 1mm and the clinical status of a patient if activating the cath lab based on aVR and concern for a STEMI
Differential Diagnosis
Isolated elevation AVR is poorly specific for a LMCA. The following are other causes of aVR elevation
- Nontraumatic thoracic aortic dissection
- Massive Pulmonary Embolism
- Massive GI bleed
- Left Bundle Branch Block (LBBB)
Left Ventricular Hypertrophy (LVH) with Strain Pattern Severe Atrial Tachydysrhythmias
External Links
References
- ↑ Kosuge M et al. Predictors of Left Main or Three-Vessel Disease in Patients Who Have Acute Coronary Syndromes with Non-ST-Segment Elevation. Am J Cardiol 2005; 95: 1366 – 9. PMID: 15904646