Beware of ST Depression in ECG Lead aVL

A retrospective study finds that ST-segment depression in ECG lead aVL can differentiate pericarditis from inferior STEMI.

Inferior ST-segment elevations are common in pericarditis, which must be differentiated from ST-elevation myocardial infarction (STEMI). To assess whether ST depression in electrocardiogram lead aVL is an indicator of STEMI, investigators reviewed the charts of patient from three groups: 154 with inferior STEMI; 49 with pericarditis and at least 0.5-mm elevation of at least 1 inferior lead ST segment; and 54 with subtle inferior STEMI, as indicated by ≤1-mm ST elevation in inferior leads.

Some degree (at least 0.25 mm) of ST depression in lead aVL was detected in 100% of patients with inferior STEMI, 0% with pericarditis, and 91% with subtle inferior STEMI.

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Beware of ST Depression in ECG Lead aVL

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Reviewing Author