ECG Quiz 44

ECG Quiz 44

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Which is likely to be the culprit artery? What is the basis for your conclusion?

Discussion

ECG shows sinus rhythm at around 100/min, with ST segment elevation in aVR and V1. ST depression is seen in I, II, III, aVF, V3-V5. Maximum ST depression is noted in V4 and V5 and it is downsloping. Duration of ST elevation in aVR is more than that in V1. Overall it is likely to be due to left main coronary artery disease. Alternate option is proximal multivessel coronary stenosis. But proximal left anterior descending coronary artery stenosis should have produced some ST elevation in V2. Here ST segment is isoelectric in V2.

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