Correlation between Electrocardiogram and Coronary Angiography in ACS with Persistent ST Segment Elevation: Institutional Cross-sectional Study

Background: The electrocardiogram provides more information on the exact location of the lesion, prediction of the final infarct size, and estimation of the prognosis. Nevertheless, coronary angiography remains the gold standard for identifying the culprit artery. The aim of our work is to study the correlation between electrical and coronary data and to determine the reproducibility of the electrocardiogram in the identification of the culprit lesion.

Methods: This is a retrospective study of 91 cases of ST+ ACS, collected in the cardiology department B of the Souissi maternity hospital over a 6-month period.

Results: The mean age of the general population was 59.5 ± 9.2 years with 78% men and 22% women, 80% of whom were menopausal. The percentage of patients with typical infarct chest pain was 95%.

Electrically, the electrocardiogram showed ST-segment elevation in all patients. The anterior territory was affected in 64.8% of cases, nearly half of which were extensive anterior. The inferior territory was affected in 25 patients (27.5%).

Angiographic analysis of the lesions showed monotruncal coronary involvement in almost half of the cases. The majority of cases (65.6%) involved the anterior interventricular artery.

Conclusions: The ECG remains an essential tool in the early identification of the artery responsible for the infarction to guide the revascularisation procedure.

The combination of ECG and coronary angiography is essential for better assessment of acute myocardial infarction in order to optimize its management.