الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Inferior myocardial infarctions account for 40-50% of all acute myocardial infarctions and are generally having a more favourable prognosis than anterior wall infarctions. However, nearly 50% of patients having inferior infarction will have complications associated with an increased mortality that will alter favourable prognosis such as right ventricular involvement and conduction disturbances.
In anterior myocardial infarction (MI) the occlusion is nearly always in the left anterior descending coronary artery (LAD), with inferior MI, however, either the right coronary artery (RCA) or the left circumflex coronary artery (LCX) may contain the culprit lesion, and mortality and morbidity in part are determined by the location of the occlusion. AMI due to occlusion in the RCA usually have a poorer outcome than do those with occlusion of the LCx, mainly due to associated complications.
So, from a clinical point of view The early and accurate identification of the infarct-related artery from the ECG can help physicians to predict the location of myocardium at risk and guide the decisions regarding the urgency of revascularization and reperfusion strategy in emergent management. Identifying the culprit coronary artery in acute myocardial infarction (AMI) in the inferior wall helps define patients who are most likely to benefit from aggressive reperfusion strategies.
Coronary angiography is the gold standard for determining the infarct related artery in acute myocardial infarction. However, when the right and left circumflex (LCx) coronary arteries present disease, correct identification of the culprit vessel can be challenging and prove to be a dilemma for the operator during a primary coronary intervention. the ECG can be useful tool in identifying which artery is involved at first point of care. Several ECG criteria depend on ST-segment changes have been proposed to identify the culprit coronary artery in inferior wall acute myocardial infarction.