View source for AVR ST elevation

==Overview==
*AVR elevation is commonly thought of as a sign of Left Main Coronary Artery (LMCA) occlusion.  However, STE 0.5mm or greater in lead aVR to be present in 78% of patients with and 14% of patients without LMCA stenosis.<ref>Kosuge M et al. Predictors of Left Main or Three-Vessel Disease in Patients Who Have Acute Coronary Syndromes with Non-ST-Segment Elevation. Am J Cardiol 2005; 95: 1366 – 9. PMID: 15904646</ref> 
*Use > 1mm and the clinical status of a patient if activating the cath lab based on aVR and concern for a [[STEMI]]
==Differential Diagnosis==
Isolated elevation AVR is poorly specific for a LMCA. The following are other causes of aVR elevation
*Nontraumatic thoracic aortic dissection
*Massive [[Pulmonary Embolism]]
*Massive [[GI bleed]]
*[[Left bundle branch block]] (LBBB)
*Left Ventricular Hypertrophy (LVH) with Strain Pattern
*Severe Atrial Tachydysrhythmias

{{ST elevation DDX}}

==External Links==
[http://traffic.libsyn.com/rebelcast/STE_in_aVR_with_Amal_Mattu.mp3 Amal Mattu aVR podcast]
==References==
<references/>

[[Category:Cardiology]]