急性下壁心肌梗死相关动脉的心电图表现

目的 对急性下壁心肌梗死患者入院时心电图与冠脉造影对照以探讨梗死相关动脉(IRA)与心电图关系。方法 对94例急性下壁心肌梗死患者入院心电图进行回顾分析,所有病人于发病3周内行冠脉造影检查,将病人分为两组。结果78例IRA为无左旋支(LCX)狭窄的右冠状动脉(RCA)病变组。ST_Ⅲ段抬高>ST_Ⅱ在RCA组56例(71.7％)而16例无RCA狭窄的LCK病变组无1例(0％);ST_(aVL)段压低>ST_1压低,RCA组54例(69％)、LCX组2例(12.5％);ST_(V1V2)段压低LCX组14例(88％),RCA组14列(18％);RCA组ST_(V7-V9)段抬高4例(5％),LCX组12例(75％);RCA组ST_(V3R-5R)抬高36例(46％),而LCX无1例(0％)。它们之间P值均少于0.001,有非常显著差异性。结论ST_Ⅲ段抬高>ST_Ⅱ、ST_(aVL)压低>ST_Ⅰ、ST_(V1-V2)压低及V(7-9)和V_(3R-5R)ST段抬高对急性下壁心梗时IRA对临床有一定价值。     

aVR导联对急性下壁心肌梗死患者梗死相关血管判断的价值

目的探讨心电图(ECG)对急性下壁心肌梗死(MI)患者梗死相关血管(IRA)判断的价值。方法选择2002年7月～2004年12月的急性下壁MI患者90例,回顾性分析其症状发作后24h内ECG改变。结果90例中,IRA为右冠状动脉(RCA)者70例,为左回旋支(LCX者)20例;Ⅰ导联ST段抬高和(或)V1和V2导联ST段压低提示IRA在LCX,而ST段抬高Ⅲ导联大于Ⅱ导联和(或)导联V4RST段抬高≥0.5mm提示IRA在RCA;aVR导联ST段压低≥1mm判断IRA为LCX,其敏感性为70.0%,特异性为94.3%。结论Ⅰ导联ST段抬高、ST段抬高Ⅲ导联>Ⅱ导联、导联V4RST段抬高≥0.5mm、V1和V2导联ST段抬高或压低以及aVR导联ST段压低等5项标准可用于判断急性下壁MI患者的IRA,而aVR导联ST段压低为一项新的标准。     

急性下壁心肌梗死患者心电图胸前导联ST段改变的临床意义

目的探讨急性下壁心肌梗死患者心电图胸前导联ST段改变与冠状动脉造影(CAG)所见冠状动脉病变部位的关系及其临床意义。方法 187例急性下壁心肌梗死患者,按入院时18导心电图胸前导联ST段改变分为3组,ST段无变化组(47例),ST段抬高组(16例),ST段压低组(124例);所有患者均行CAG。结果急性下壁心肌梗死伴胸前导联ST段抬高时多为右冠状动脉(RCA)近段闭塞(14例,82.3%),尤其是伴圆锥支动脉闭塞,与RCA中远端闭塞(2例,5.9%)比较差异有统计学意义(P0.01),且14例(73.7%)伴有右心功能不全和血流动力学障碍。下壁心肌梗死胸前导联ST段压低者可见于RCA、回旋支(LCX)闭塞及RCA、LCX闭塞与前降支(LAD)、对角支(D)病变的不同组合,其中LCX闭塞伴RCA病变者多表现为朐前ST V_4～V_6的压低,RCA闭塞伴LAD近端病变多有胸前ST V_1～V_6的压低,RCA伴D病变胸前ST V_1～V_3压低,与对照组比较差异有统计学意义(P0.05)。结论急性下壁心肌梗死合并胸前导联ST段抬高表明为RCA近段或丌口闭塞且多伴右心室心肌梗死和心功能不全;下壁心肌梗死伴胸前导联ST段压低提示为多支病变,ST V_1～V_3压低多伴有对角支严重狭窄,STV_1～V_6压低多伴有前降支的严重狭窄。     

急性心肌梗死时体表心电图对梗死相关动脉的判断

目的了解急性心肌梗死(AMI)的体表心电图对心肌梗死相关动脉(IRA)及其闭塞位置判断作用.方法对264例急性心肌梗死患者的心电图和冠状动脉造影资料进行回顾性对比分析.结果①下壁AMI时血管闭塞发生在右冠状动脉(RCA)74例(78.7%),左回旋支(LCX)20例(21.3%).Ⅰ、aVL导联ST段压低提示RCA为IRA的敏感性,特异性和阳性预测值分别为94.6%,70%和92.1%.ST段压低Ⅰ＜aVL提示RCA为IRA的敏感性,特异性和阳性预测值分别为83.8%,90%和96.9%.ST段抬高Ⅱ＜Ⅲ提示RCA为IRA的敏感性,特异性和阳性预测值分别为90.5%,90%和97.1%.ST段压低Ⅰ＜aVL和ST段抬高Ⅱ＜Ⅲ提示RCA为IRA的敏感性,特异性和阳性预测值分别为81.8%,100%和100%.非ST段压低Ⅰ＜aVL和非ST段抬高Ⅱ＜Ⅲ提示LCX为IRA的敏感性,特异性和阳性预测值分别为85%,100%和100%.13例合并右室心梗IRA均为RCA.②前间壁AMI时STⅠ、STaVL抬高,STⅡ、Ⅲ、aVF下降均不能提示IRA为LAD或RCA(P分别大于0.05).③前壁AMI时STⅠ、STaVL抬高,STⅡ、Ⅲ、aVF下降判断LAD近段闭塞的敏感性、特异性和阳性预测值分别为70.4%,59.3%,87%,95.7%和86.4%,94.1%.④广泛前壁AMI时STⅠ、STaVL抬高,STⅡ、Ⅲ、aVF下降判断LAD近段闭塞的敏感性、特异性和阳性预测值分别为100%,95.5%,85.7%,100%和97.8%,100%.结论下壁、前壁和广泛前壁AMI时体表心电图对心肌梗死相关动脉(IRA)及其闭塞位置判断具有预测价值.     

心电图ST段改变判断急性下壁心肌梗死患者梗死相关血管的意义

目的探讨急性下壁心肌梗死时心电图ST段改变对心肌梗死梗死相关动血管(IRA)的判断价值。方法通过对84例急性下壁心肌梗死的患者的心电图Ⅰ、aVL、Ⅱ、Ⅲ、aVR、V5、V6导联ST段偏移进行分析,并与冠状动脉造影结果进行对比。结果 (1)IRA为右冠状动脉(RCA)68例,左冠状动脉回旋支(LCX)16例。(2)ST↑ⅢST↑Ⅱ提示IRA为RCA的敏感性是93%,特异性是94%,阳性预测值(PPV)是98%,阴性预测值(NPV)是79%;ST↑ⅢST↑Ⅱ提示IRA为LCX的敏感性是81%,特异性是97%,PPV是87%,NPV是96%。(3)ST↓V3/ST↑Ⅲ的值0.5提示IRA为RCA的敏感性是90%,特异性是94%,PPV是98%,NPV是68%;ST↓V3/ST↑Ⅲ的值1.2提示IRA为LCX的敏感性是81%,特异性是97%,PPV是87%,NPV是97%。(4)ST↓aVLST↓I提示IRA为RCA的敏感性是91%,特异性是81%,PPV是95%,NPV是68%。(5)aVR导联ST段压低提示IRA为RCA的敏感性是88%,特异性是87%,PPV是97%,NPV是64%;aVR导联ST段抬高提示IRA为LCX的敏感性是81%,特异性是94%,PPV是76%,NPV是95%。(6)Ⅱ、Ⅲ、aVF导联ST段抬高伴V5、V6导联ST段抬高对梗死相关血管为RCA或LCX无预测价值。结论常规12导联心电图ST段偏移对判断急性下壁心肌梗死梗死相关血管有重要的预测价值。     

体表心电图预测下壁心肌梗塞的梗塞相关动脉

目的 探讨下壁急性心肌梗塞的初始心电图能否预测梗塞相关动脉(IRA)以及合并存在的冠状动脉病变是否会改变这种预测能力.方法 102例下壁AMI病人在入院时记录标准十二导联心电图的ST段移位情况,并在住院期间行冠状动脉造影确定IRA,分析心电图ST移位与梗塞相关动脉的关系.结果(1)双左回旋支(LCX)为IRA的病人和以右冠状动脉(RC)为IRA的病人相比,前者V_1或V_2导联ST段压低的发生率明显高于后者(分别为80%和43%,P<0.01),前者I导联ST段抬高或位于等电位线的发生率也高于后者(分别为63%和27%,P<0.05);(2)根据V_1或V_2导联ST段压低判断LCX为IRA的敏感性、特异性和阴性预测值分别为83%、56%和93%.结论 下壁AMI时V_1或V_2导联ST段压低是判断LCX作为IRA敏感指标,并具有很高的阴性预测值,合并存在的冠状动脉病变不会改变这种预测能力.     

急性下壁心肌梗死ST段改变特征的分析

目的结合冠状动脉造影结果,分析急性下壁心肌梗死患者心电图ST段改变的特征,探讨梗死相关动脉(IRA)的判定。方法选择197例急性下壁心肌梗死,其中右冠状动脉近段闭塞69例、右冠状动脉远段闭塞80例、回旋支(LCX)闭塞48例,患者胸痛发作12h内的心电图。结果三组以及导联间比较,右冠状动脉(RCA)闭塞可出现STaVR压低(p<0.05),同时STⅢ↑>STⅡ↑(p<0.05),STaVL压低较STI明显(p<0.05),与RCA闭塞的部位无关。结合三者,其预测RCA闭塞的敏感性84%、特异性90%、阳性预测值96%、阴性预测值60%。结论急性下壁心肌梗死早期除下壁导联ST抬高外,STⅢ↑>STⅡ↑、STaVL↓>STⅠ↓、STaVR↓提示RCA阻塞,是区别RCA闭塞或LCX闭塞的关键指标,对预后和决定是否采取血管重建治疗具有重要的参考价值。     

急性下壁心梗右冠不同闭塞节段心电图差异

目的回顾性分析急性下壁心肌梗死(IAMI)患者右冠状动脉(RCA)不同闭塞节段的心电图(ECG)差异,评估其应用价值,期望发现新的ECG预测标准。方法收集本院6年间符合标准的IAMI患者,对不同RCA闭塞节段的ECG特征进行比较分析。结果 58例患者,男性51例,女性7例,平均年龄65.00±13.61岁。ST_(V1)抬高≥0.5mm对提示RCA近段闭塞有显著的统计学意义(p=0.001)。ST_(V3)压低/ST_(Ⅲ)抬高比率0.5、ST_(V4R)抬高在RCA近段组的出现率明显高于中远段组(80.95%vs.50.00%,p=0.058、91.67%vs.60.00%,p=0.191),但差异无统计学意义。结论 ST_(V1)抬高与否对判断急性下壁心肌梗死RCA闭塞节段具有良好的预测价值,若能联合STV3抬高/ST_(Ⅲ)压低比率以及ST_(V4R)抬高与否做共同分析,将进一步提高诊断的灵敏度和特异性。     

急性心肌梗死冠脉造影与心电图相关性研究

目的探讨急性心肌梗死患者冠状动脉狭窄情况与心电图表现的相关性。方法选取我院2014年1月~2015年1月收治的急性心肌梗死患者55例为研究对象,对其冠状动脉造影结果与心电图表现进行研究。结果选取我院2014年1月~2015年1月收治的急性心肌梗死患者55例为研究对象,梗死相关动脉(IRA)为前降支(LAD)共有35例,其中30例除前壁相应导联ST段抬高外,其余导联ST段压低与合并狭窄血管相对应(约占85.71%),另5例ST段压低导联无对应合并狭窄血管(约占14.29%)。IRA为右冠状动脉(RCA)共有15例,其中14例除下壁、右室、左室后壁相应导联ST段抬高外,其余导联ST段压低与合并狭窄血管相对应(约占93.33%),另1例ST段压低导联无对应合并狭窄血管(6.67%)。IRA为回旋支(LCX)共有7例,其中4例除下壁、左室后侧壁相应导联ST段抬高外,其余导联ST段压低与合并狭窄血管相对应(约占57.14%),另3例ST段压低导联无对应合并狭窄血管(约占42.86%)。结论急性心肌梗死时,IRA会引起心电图相应导联ST段抬高,其他合并狭窄病变血管亦会引起相应导联ST段压低改变。     

体表心电图对老年急性下壁心肌梗死患者梗死相关血管的预测价值

目的探讨体表心电图对老年急性下壁心肌梗死患者梗死相关血管(IRA)的预测价值。方法对70例老年急性下壁心肌梗死患者的入院心电图和冠状动脉造影资料进行回顾性分析,寻找可以预测IRA的心电图改变。结果70例老年急性下壁心肌梗死患者中,IRA为左前降支(LAD)者3例(4%),右冠状动脉(RCA)者53例(76%),左回旋支动脉(LCx)者14例(20%)。经χ2检验,STV1抬高、STⅢ抬高>STⅡ抬高、STⅠ和(或)STaVL压低、STV3压低/STⅢ抬高≤1.2等4项指标提示RCA为IRA。其中,STV1抬高的特异度和阳性预测值最高,均为100%;灵敏度则以STI和(或)STaVL压低为最高,达94%。反之,STV1压低、STⅢ抬高≤STⅡ抬高、STⅠ和(或)STaVL抬高、STV3压低/STⅢ抬高>1.2提示LCx闭塞可能性大。其中灵敏度和阴性预测值以STV1压低为最高,分别为71%和89%,特异度和阳性预测值则以STⅠ和(或)STaVL抬高为最高,均为100%。结论急性下壁心肌梗死时,体表心电图对预测IRA有重要价值。     

Electrocardiographic discrimination of infarct-related artery between left circumflex and right coronary artery: comparison of ST elevation between leads II and III

OBJECTIVES: Admission electrocardiography was evaluated to discriminate left circumflex artery (LCX) versus right coronary artery (RCA) as the cause of acute myocardial infarction. METHODS: Electrocardiographic findings were assessed in patients with RCA (n = 60) and LCX (n = 60) occlusion. RESULTS: ST segment elevation in the inferior leads or right precordial leads was more common in the RCA group. ST segment depression or negative T wave was more common in leads I, aVL in the RCA group. ST segment elevation was more common in leads V5, V6 in the LCX group. ST segment was elevated in inferior leads in 55 patients in the RCA group and 27 patients in the LCX group. Mean ST level was higher in lead III than in lead II in the RCA group, but not in the LCX group. The ST level was higher in lead III than in lead II in 78% of the RCA group, but only 44% of the LCX group (p < 0.01). CONCLUSIONS: Comparison of ST levels between leads II and III, and a three-dimensional analysis in 12-lead electrocardiography is useful for discriminating the left circumflex artery from the right coronary artery as the cause of acute myocardial infarction.     

心电图对老年急性下壁心肌梗死冠状动脉病变部位的预测价值

目的　探讨急性下壁心肌梗死心电图与冠状动脉病变的关系 ,以揭示体表心电图对梗死相关动脉及病变节段的预测价值。方法　对 15 6例老年急性下壁心肌梗死患者的体表心电图和冠状动脉造影资料进行对比分析。结果　梗死相关动脉为右冠状动脉占 79.5 % ,左回旋支占 2 0 .5 %。单纯急性下壁心肌梗死病变节段多发生在第一右心室支开口以远 (77.6 % ) ,合并右心室心肌梗死病变节段多发生在第一右心室支开口前 (87% )。STⅢ 抬高 /STⅡ 抬高 >1,STⅠ、aVL下移≥ 1mm ,提示右冠状动脉为梗死相关动脉的敏感性分别为 87.9%、89.5 % ,特异性分别为 84 .4 %、81.2 % ,阳性预告值分别为 95 .6 %、94 .8% ,两者差异无显著性意义 (P >0 .0 5 )。ST段V1、V2 下移≥ 1mm ,提示左回旋支为梗死相关动脉的敏感性 ,特异性和阳性预告值分别为 84 .4 %、91.9%、73.0 %。结论　急性下壁心肌梗死时心电图对判断梗死相关动脉及病变节段有重要的预测价值     

心电图对急性下壁心肌梗死患者梗死相关血管及闭塞部位的预测价值

目的:探讨急性下壁心肌梗死患者的体表心电图对梗死相关血管及闭塞部位的预测价值。方法:对62例急性下壁心肌梗死患者的体表心电图和冠状动脉造影资料进行回顾性对比分析。结果:梗死相关血管为右冠状动脉者50例(80.65%),左回旋支者12例(19.35%)。单纯急性下壁心肌梗死多发生在右冠状动脉中远段(62.07%);并发右室梗死者均发生在右冠状动脉,且多发生在右冠状动脉近段(70.00%)。STⅢ抬高/STⅡ抬高>1、STaVL压低≥0.5mm、STV1抬高≥0.5mm、STV3压低/STⅢ抬高≤1.2提示梗死相关血管为右冠状动脉的灵敏度分别为88.00%、90.00%、66.00%、72.00%,特异度分别为58.33%、75.00%、83.33%、66.67%。STⅢ抬高/STⅡ抬高≤1、STaVL呈等电位线或抬高、STV1压低≥0.5mm、STV3压低/STⅢ抬高>1.2提示梗死相关血管为左回旋支的灵敏度分别为58.33%、75.00%、66.67%、66.67%,特异度分别为88.00%、90.00%、80.00%、72.00%。结论:急性下壁心肌梗死时,体表心电图对梗死相关血管及闭塞部位有重要的预测价值。     

Electrocardiographic identification of the infarct-related artery in acute inferior myocardial infarction.

INTRODUCTION: Mortality and morbidity from acute inferior myocardial infarction (MI) are determined, among other factors, by the infarct-related artery (IRA). Several electrocardiographic (ECG) criteria have been proposed to differentiate between the right coronary artery (RCA) and the left circumflex coronary artery (LCx) as the IRA in inferior MI. Recently, a new criterion has been proposed (ST segment depression in lead aVR). It was our objective to evaluate the old and the new ECG criteria in identifying the IRA in patients with inferior MI. METHODS: Patients with inferior MI treated by primary angioplasty were included, following evaluation of the admission ECG. Patients with a previous history of Q-wave myocardial infarction and complete bundle branch block were excluded. The artery with the most severe lesion was considered the IRA. The following ECG criteria were assessed: ST depression in lead DI; ST depression in leads V1 and V2, ST elevation in lead DIII > DII, ST depression in V3/ST elevation in DIII ratio > 1.2 (classical criteria) and ST depression in lead aVR. ST-segment elevation or depression was measured 0.06 sec after the J point. RESULTS: 53 patients were included (mean age 59.1 +/- 13.9 years, 38 males). The RCA was the IRA in 38 patients and the LCx in 15. Baseline characteristics (age, gender, TIMI flow, Killip class, and pain-to-balloon time) were similar in both groups. All the classical criteria were able to identify the IRA. The new criterion--ST depression in lead aVR--identified the IRA in a small number of patients (sensitivity 33%, specificity 71%, p = NS). CONCLUSIONS: The 4 classical criteria were useful in identifying the IRA in patients with inferior MI. ST depression in lead aVR (a recently proposed new criterion), on the other hand, showed limited utility in differentiating between RCA and LCx.     

246例回旋支不同节段闭塞的心电图特点

目的探讨回旋支闭塞中不同节段,不同优势型,多支病变对心电图变化的影响。方法本研究共入选246例发生急性LCX闭塞的患者（其中男187例,女59例）,根据冠脉造影结果将患者根据冠脉优势型、单支、多支、合并LAD、RCA分组,结合年龄、性别及相关危险因素,对比分析心电图改变与冠脉造影结果及临床特点的关系。结果回旋支闭塞心电图变化受不同冠脉优势型影响,Ⅱ、Ⅲ、aVF、V7~V9导联ST段抬高常见于左优势型的LCX闭塞。V1~V3导联ST段压低常见于均衡型的LCX闭塞,Ⅰ、aVL导联ST段抬高在各优势型中无特异性。在单支LCX闭塞中,V1~V3导联ST段压低常见于近段闭塞,Ⅱ、Ⅲ、aVF导联ST段抬高常见于远段闭塞,V7~V9导联ST段抬高与Ⅰ、aVL导联ST段抬高在各节段闭塞的心电图中无特异性。合并多支病变时LCX心电图变化与单纯LCX闭塞存在差异,在LCX近段闭塞中,合并多支病变的患者更易出现V7~V9导联ST段抬高,单支病变者心电图易出现V1~V3导联ST段压低,在LCX中段闭塞的患者中,单支病变与多支病变的心电图改变大致相同。在LCX远段闭塞的患者中,多支病变患者出现V1~V3导联ST段压低可能性较大。OM闭塞在单支及合并多支病变时的心电图差异无明显统计学意义。在合并LAD或RCA病变的LCX闭塞患者中,心电图改变无明显差异。结论心电图对诊断梗死相关动脉为回旋支的急性心肌梗死有重要的预测价值,结合病史及相关一般资料可对急性心肌梗死患者的预后进行评估。     

36例回旋支为梗死相关动脉的急性下壁心肌梗死的心电图特点

目的分析回旋支为梗死相关动脉的急性下壁心肌梗死(简称心梗)的心电图表现,总结其心电图特点。方法回顾性分析本院经冠状动脉造影证实回旋支为梗死相关动脉的急性下壁心梗患者36例,分为ST↑Ⅲ<Ⅱ组(n=8),ST↑Ⅲ=Ⅱ组(n=19)和ST↑Ⅲ>Ⅱ组(n=9)三组,分析发病12 h内的18导联心电图特点。比较三组冠状动脉优势型及病变部位。结果 ST↑Ⅲ<Ⅱ组STⅠ、aVL抬高、等电位线、压低的发生率分别为50%,12.5%,37.5%;ST↑Ⅲ=Ⅱ组相应的发生率分别为10.5%,31.6%,57.9%;ST↑Ⅲ>Ⅱ组相应的发生率分别为0,11.1%,88.9%。ST↑Ⅲ<Ⅱ组STV4-6抬高、等电位线、压低的发生率分别为87.5%,0,12.5%;ST↑Ⅲ=Ⅱ组相应的发生率分别为78.9%,21.1%,0;ST↑Ⅲ>Ⅱ组相应的发生率分别为66.7%,0,33.3%。三组患者冠状动脉优势型的比较有差异(P<0.05),三组STV7-9形态、STV3R-5R形态、冠状动脉病变部位无差异(P均>0.05),三组均无房室传导阻滞的发生。结论回旋支为梗死相关动脉的急性下壁心梗ST↑Ⅲ<Ⅱ时常合并STⅠ、aVL抬高,ST↑Ⅲ=Ⅱ、ST↑Ⅲ>Ⅱ时常合并STⅠ、aVL压低;回旋支为梗死相关动脉的急性下壁心梗累及右室时也可表现为ST↑V3R-5R;回旋支为梗死相关动脉的急性下壁心梗不易发生房室传导阻滞。     

The Value of Exercise Electrocardiography and Exercise Thallium-201 Myocardial Perfusion Scanning in Determining the Presence of Single Vessel Coronary Artery Obstruction

Summary: In 39 patients with single vessel coronary artery disease and no previous myocardial infarction, exercise thallium-207 myocardial perfusion scanning and 12 lead exercise electrocardiography (ECG) were compared to see how reliably each method identified the site of coronary artery obstruction. Significant (≥ 70% diameter) stenosis was present in the left anterior descending (LAD) coronary artery in 21 patients, in the right coronary artery (RCA) in 14 patients and in the left circumflex (LCX) in four patients. Thallium defects on the scan in the septa1 (SEPT), anteroseptal (ANT SEPT) and anterior (ANT) segments correlated (P < 0.0005) with LAD disease and defects in the inferior (INF), posteroinferior (POST INF), and posterior (POST) segments correlated (P < 0.0005) with RCA or LCX disease. Exercise induced ST segment elevation in VI and/or AVL correlated with LAD disease. The site of ischaemic ST depression did not correlate with disease in any vessel. ST segment depression in leads L2, 3, AVF (67%) and in leads V4–6 (67%) was most sensitive for detecting patients with LAD disease and ST depression in leads V4–6 was most sensitive (56%) for detecting patients with RCA or LCX disease but neither differentiated LAD from RCAILCX disease.
During exercise induced ischaemia, the site of ST segment depression on the 12 lead exercise ECG will not identify the area of ischaemia in patients with single vessel disease but thallium defects will. In contrast to ST depression, ST elevation in V1 and/or AVL may identify LAD stenosis.     

Differentiating the infarct-related artery on initial electrocardiogram in single or multi-vessel disease in acute inferior myocardial infarction and evaluating involvement of vessels using correspondence analysis

Initial electrocardiography changes were compared prospectively with the findings of coronary angiography to predict the infarct-related artery (IRA) in cases of single- and multi-vessel disease and to demonstrate the relationship between other coexisting coronary involvements and IRA in patients who presented with acute inferior myocardial infarction (AMI). ST elevations or depressions of at least 1 mm (0.1 mV) were evaluated in the leads I, aVL, and V1-V6. Of the 160 patients hospitalized due to inferior AMI, 153 (96%) underwent coronary angiography using standard methods. The angiograms were screened for stenotic lesions using quantitative coronary angiography to confirm significance, which was considered >50% vessel lumen diameter reduction. Among single-vessel involvements, the IRA was either the circumflex artery (Cx) or right coronary artery (RCA). In conditions in which IRA was detected as either Cx or RCA, 1-, 2-, and 3-vessel involvements were also detected. Correspondence analysis was performed to show the vessel involvements accompanying IRA. Compared with patients with IRA as RCA, the presence of ST depressions in the leads V1 or V2 and aVL were more frequently seen in patients with IRA as Cx (p=0.000, p=0.015, respectively). Among all vessel involvements in which IRA was either Cx or RCA, a ST-segment depression in leads V1 or V2 (p=0.000) and aVL (p=0.000) and a ST-segment elevation in lead I (p=0.005) were considered to be significant for Cx, and a ST-segment depression in lead I for RCA involvement (p=0.010). According to correspondence analysis, the most frequent single-vessel involvement seen in inferior AMI was RCA; when IRA was RCA, a multi-vessel involvement included RCA and Cx; and when IRA was Cx, a single-vessel involvement included the left anterior descending (LAD) artery most frequently, and RCA+LAD less frequently (p=0.000). In inferior AMI, RCA was the most common IRA; however, the possibility of multi-vessel disease is increased when Cx is found to be the IRA. In patients presenting with inferior AMI, the presence of ST-depression in the leads aVL and V1-2 is a sensitive finding that indicates Cx stenosis rather than RCA stenosis and is not affected by coexisting other coronary artery involvements.