ECG Quest > Ischemia > ST depression and ischemia > Left main occlusion

Left main occlusion

Left main occlusion and stenosis are commonly confused. A Left Main Coronary Artery (LMCA) stenosis can cause widespread ST depression and ST elevation in aVR, but unlike with a proximal LAD occlusion, the ST elevation in aVR is greater than in V1. It is likely that many cases reported as left main occlusion with this pattern have sub-total occlusion (stenosis). A true occlusion has a high risk of cardiac arrest and may show widespread massive ST elevation with ST depression in aVR.

See also: ST depression and ischemia

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In the ECGquest archives, this ECG has been tagged with: - Chest pain Bradycardia Normal Axis Regular Anterior ST elevation Inferior ST elevation Lateral ST elevation Shark fin ST elevation Widespread ST elevation Left main occlusion 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Total eclipse of the heart – 40 min later with crushing chest pain

This ECG is from a man in his 50s who presented with chest pain radiating to the left side and back, nausea, diaphoresis and bilateral finger tingling sensation. This was the repeat ECG 40 min after arrival when he had a sudden recurrence of crushing chest pain and appeared critically ill.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Bradycardia Electrode Detachment Normal Axis Regular Anterior ST elevation Inferior ST elevation Lateral ST elevation Shark fin ST elevation Widespread ST elevation Left main occlusion 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Total eclipse of the heart – 41 min later with crushing chest pain, just before arrest

This ECG is from a man in his 50s who presented with chest pain radiating to the left side and back, nausea, diaphoresis and bilateral finger tingling sensation. This was the repeat ECG about 41 min after arrival, with recurrent crushing chest pain, just before he arrested.

In the ECGquest archives, this ECG has been tagged with: - Regular Short QRS Left main occlusion 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Total eclipse of the heart – after placement of LVAD

This ECG is from a man in his 50s who presented with chest pain radiating to the left side and back, nausea, diaphoresis and bilateral finger tingling sensation. This was the repeat ECG post-arrest after angiogram showing left main occlusion and placement of an LVAD.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Inferior ST elevation Left main occlusion 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Total eclipse of the heart

This ECG is from This ECG is from a man in his 50s who presented with chest pain radiating to the left side and back, nausea, diaphoresis and bilateral finger tingling sensation.