Suerte,
JL



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Note added at 2002-04-18 15:49:07 (GMT)
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\"Así, en infartos inferiores en que habitualmente el ST está descendido en I, aVL y a veces en precordiales (imagen especular), aparece elevación de ST en estas derivaciones en caso de desarrollar pericarditis, persistiendo sólo aVR con ST descendido. De forma similar, en casos de IAM laterales, se elevará el ST en II, III y aVF si se desarrolla pericarditis 87 . En cualquier caso, se puede concluir diciendo que la pericarditis origina alteraciones del ECG con mucha frecuencia, pero que estas alteraciones son poco específicas, por lo que la interpretación es dificil y, por tanto de escaso valor diagnóstico...\"

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Note added at 2002-04-18 15:50:37 (GMT)
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Results: ST segment \"dissociation\" was found in almost half the pts with infero- lateral AMI. Namely, 50 pts had ST ¡è in V5 and V6, together with ST ¡è in aVL and lead I. LVEF was low (28.9¡¾6.2%) and mortality high (18%) in \"ST dissociation\" group. Many of them (64%) had specific ECG sign of RV involvement (ST ¡è ¡© in V4R >1mm). The probable explanation for \"ST segment dissociation between V5&V6 from I&aVL\": ST¡© in V5&V6 is the result of \"local\" lateral wall lesion (and is not much affected by the current lesion in frontal plane). Logically, we might also expect ST ¡è in \"other lateral leads\" (aVL&I). But, it may not happen, because aVL&I are influenced importantly by the direction of current lesion in frontal plane, which is in RV AMI toward right and down. This is recognized as ST ¡è in inferior leads and V4R, together with \"mirror image\" ST ¡è in I&aVL. Thus, \"mirror image\" (from inferior and RV AMI) overwhelms in aVL and lead I the \"local\" impact (from lateral AMI).