Lead Avl on Electrocardiogram: Emerging as Important Lead in Early Diagnosis of Myocardial Infarction?

Authors

Getaw Worku Hassen, Department of Emergency Medicine, NYMC, Metropolitan Hospital Center, New York, NY; Department of Emergency Medicine, Mount Sinai School of Medicine, Lutheran Medical Center, New York, NY; Department of Emergency Medicine St George's University School of Medicine, Lutheran Medical Center, New York, NY. Electronic address: getawh@yahoo.com.
Soheila Talebi, Department of Internal Medicine, Metropolitan Hospital Center, New York, NY.
George Fernaine, Department of Cardiology, Mount Sinai School of Medicine, Lutheran Medical Center, New York, NY.
Hossein Kalantari, Department of Emergency Medicine, NYMC, Metropolitan Hospital Center, New York, NY.

Author Type(s)

Faculty

DOI

10.1016/j.ajem.2014.02.038

Journal Title

The American Journal of Emergency Medicine

First Page

785

Last Page

8

Document Type

Article

Publication Date

7-1-2014

Abstract

Although a diagnosis of acute myocardial infarction (AMI) that mandates emergency reperfusion therapy requires ST-segment elevation greater than 1 mm in at least 2 contiguous leads, some of the early electrocardiogram (ECG) changes of AMI can be subtle. Any ST-segment depression or T-wave inversion in lead aVL may be implicated in left anterior descending artery lesion or early reciprocal changes of inferior wall myocardial infarction, particularly when the clinical context suggests ischemia. Early recognition of reciprocal changes and serial ECG help initiate early appropriate intervention. Heightened awareness of ST segment and T-wave changes in lead aVL is of paramount importance to quickly identifying life-threatening condition.

Recommended Citation

Hassen, G. W., Talebi, S., Fernaine, G., & Kalantari, H. (2014). Lead Avl on Electrocardiogram: Emerging as Important Lead in Early Diagnosis of Myocardial Infarction?. The American Journal of Emergency Medicine, 32 (7), 785-8. https://doi.org/10.1016/j.ajem.2014.02.038