What is proximal LAD occlusion?
Proximal occlusion within the left anterior descending (LAD) coronary artery in patients with acute myocardial infarction leads to higher mortality than does nonproximal occlusion. We evaluated an automated program to detect proximal LAD occlusion.
What ECG changes are associated with an occlusion to the left anterior descending artery?
Occlusion in the left anterior descending artery ST-segment elevations may be present in leads V1–V6, and frequently aVL, I (the latter two may be affected because the diagonals given off by the LAD supplies the apical part of the lateral wall).
What is proximal LAD in heart?
The LAD is made up of a proximal segment, middle segment, and distal segment. The proximal segment contains the first branch of the septal perforator. The middle segment is bordered by the first septal branch and represents the halfway point between the septal branch and the ventricular apex.
What is the proximal LAD?
Proximal LAD was defined according to the Coronary Artery Surgery Study classification (9): end of left main to the first large septal or first diagonal, whichever is most proximal.
What is LAD occlusion?
Abstract. Acute occlusion of the left anterior descending coronary artery (LAD) generally results in ST segment elevations in precordial leads and reciprocal ST segment depression in inferior leads. The occurrence of isolated inferior myocardial infarction due to occlusion of LAD is very rare.
Can the proximal LAD be stented?
Percutaneous transluminal coronary angioplasty with stenting (PCI) and off-pump coronary artery bypass grafting (surgery) are accepted treatments for symptomatic isolated stenosis of the proximal left anterior descending (LAD) coronary artery .
Which leads on ECG are LAD?
The septum is represented on the ECG by leads V1 and V2, whereas the lateral wall is represented by leads V5, V6, lead I and lead aVL. To make things more complicated, sometimes the LAD “wraps around” the cardiac apex, which is a common anatomic variant.
What does LAD occlusion mean?
The left anterior descending artery (also LAD, anterior interventricular branch of left coronary artery, or anterior descending branch) is a branch of the left coronary artery. Blockage of this artery is often called the widow-maker infarction due to a high death risk.
What are the symptoms of LAD?
Some of the warning signs and symptoms of a 100 percent LAD blockage include:
- feeling chest pain or discomfort.
- experiencing pain that radiates out into your arms, legs, back, neck, or jaw.
- having pain in your abdominal area that feels like heartburn.
- having muscle pain in your chest or neck that feels like a pulled muscle.
What are LAD lesions?
Proximal left anterior descending coronary artery (LAD) lesions often supply a high percentage of the left ventricular myocardium, compared to proximal lesions in the circumflex or right coronary arteries.
How long will a stent in the LAD last?
How long will a stent last? It is permanent. There is just a 2–3 per cent risk of narrowing coming back, and if that happens it is usually within 6–9 months. If it does, it can potentially be treated with another stent.
Is there an occlusion of the proximal Lad?
It would be reasonable to suspect a proximal LAD occlusion based on this ECG. However, this patient actually had severe multi-vessel disease. Angiography demonstrated a chronic total occlusion of his circumflex artery, with critical stenoses of his proximal LAD, RCA and ramus intermedius.
Are there ECG patterns that indicate significant occlusion?
Certain ACS ECG patterns, which do not include widespread ST-segment elevation, are indicative of significant arterial occlusion in the ACS patient; these patterns are, of course, associated with significant risk to the patient and mandate a rapid response. Many of these high-risk ECG patterns are well described and recognized-while others are not.
How is ECG related to anterior wall STEMI?
This ECG constellation of findings is associated with significant proximal left anterior descending artery (LAD) occlusion (Figure 4) and ultimately anterior wall STEMI. In fact, recent publications have suggested that this ECG pattern should be treated as a STEMI equivalent presentation based on angiographic evidence. 3-6
What causes a consistent ECG pattern of St depression?
ST depression does not localise, and thus subendocardial ischaemia due to oxygen supply/demand mismatch produces a consistent ECG pattern of lateral ST depression and reciprocal ST elevation in aVR