Clinical Significance of Relation Between Coronary Collateral Circulation and STscgmentff-wave Changes in Acute Myocardial Infarction

Following acute myocardial infaretion (AMI), some patients retain ST segment elevation and upright T waves, a pattern usually seen within minutes to hours of AMI, even, after 72 hours. It often identifies a transmural AMI which results from a persistent total obstruction of the infarct-related coronary artery and inadequate collateral flow. Twenty-two patients were studied to te st the hypothesis that absence of adequate callateral flow was responsible for pe rsistent ST elevation and that adequate collateral flow was associated with the more typical resolution of ST elevation. The study group consisted of 22 patients with AMI admitted to the coronary care u nit between 1995 and 1997 in whom a totally obstructed infarct-related artery by coronary angiography were observed. Group A consisted of 10 patients with an ECG demonstrating ST-segment elevation and upright T waves C.72 hours after AMI. Group B consisted of 12 patients with an ECG demansırating resolution of STsegment elevation accompanied by inversion of T waves within 72 hours of the AMI. There were no significant differences between the two groups regarding age, sex, risk factors, preinfarction angina, maximum and total reciprocal changes. Total ST segment elevation, maximum ST segment elevation were higher in group A vs group B (pKeywords: Acute myocardial infarction, collateral flow, electrocardiography