ECG manifestations of occlusion of septal perforator of left anterior descending artery

Am J Emerg Med. 2024 Aug:82:42-46. doi: 10.1016/j.ajem.2024.05.014. Epub 2024 May 18.

Abstract

The fourth universal definition of MI defines requires presence of j point elevation in two contiguous leads except v2-3 where the elevation should be equal to or >2 mm in men (2.5 mm in <40 years) and 1.5 mm in women.(1) We present two cases of patients who presented with electrocardiographic manifestations of occlusion of septal perforator of left anterior descending artery and discuss the salient feature of ECG in such patients. We also present the limitations of STEMI criteria given the dynamic nature of acute coronary occlusion and stress on early recognition of this MI.

Keywords: ACS; Conduction disturbances; First septal perforator; LAD; LSFB; PAF; RBBB; S1.

MeSH terms

  • Adult
  • Aged
  • Coronary Angiography
  • Coronary Occlusion* / diagnosis
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology
  • Electrocardiography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / physiopathology