Usefulness of ST elevation II/III ratio and ST deviation in lead I for identifying the culprit artery in inferior wall acute myocardial infarction

Am J Cardiol. 2000 Aug 1;86(3):341-3. doi: 10.1016/s0002-9149(00)00929-2.


In a study of 92 patients presenting with inferior wall acute myocardial infarction, the infarct-related artery was the right coronary artery in 72 patients (78%) and the left circumflex artery in 20 (22%). An ST II/III ratio of 1 or an isoelectric ST in lead I are sensitive and specific markers of left circumflex artery occlusion, whereas an ST II/III ratio <1 (ST elevation in lead III >II) or ST depression in lead I are sensitive and specific markers of right coronary artery occlusion.

MeSH terms

  • Adult
  • Aged
  • Coronary Angiography
  • Coronary Vessels / physiopathology
  • Electrocardiography*
  • Female
  • Heart Conduction System / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / physiopathology
  • Predictive Value of Tests