Abstract：Objective To investigate the value of electrocardiogram（ECG）in identifying the guilty artery in patients with inferior wall acute myocardial infarction（AMI）. Methods By retrospective analysis of ECGs and Coronary angiographic data of 73 patients with inferior wall AMI to find valuable ECG changes that can forecast the guilty artery（also means infarct-related artery， IRA）. Results The IRAs were right coronary artery（RCA）in 59（81%） patients and left circumflex（LCx） in 14（19%） patients. By chi-square test: Combine with right ventricular infarction and serious slow arrhythmia， ST elevation in lead V1 ≥0.5 mm，ST elevation in leadⅢ exceeding that of leadⅡ， ST depression in lead I and（or） lead aVL≥0.5mm， sum of ST depression in lead V 2and ST elevation in lead aVF>0 identified RCA occlusion. Among these criteria， ST elevation in lead Vl， ST depression in leadⅠ≥0.5 mm and combined with right ventricular infarction had the highest specificity and positive predictive value（PPV）of 100%， respectively， and ST elevation in leadⅢ exceeding that of leadⅡ had the highest sensitivity of 81%. ST depression in lead V2≥0.5 mm had the highest sensitivity of 93%in identified LCx as IRA， and ST elevation in lead aVL≥0.5 mm had the highest specificity and PPV of 100%，respectively. Conclusion ECG plays an important role in predicting the IRAs in patients with inferior wall AMI.
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2011, Vol. 20 
