Coronary anatomy and correlating ECG leads

Original chalk talk by Brandon Fainstad, MD
Edits and graphics by Yilin Zhang, MD


OBJECTIVES:

  1. Review coronary anatomy and associated distributions on an ECG
  2. Practice cases with pearls and pitfalls

Coronary anatomy, vessel distribution and associated leads on an ECG

Fill in the coronary anatomy:

  • Right coronary artery (RCA)
  • Posterior descending artery (PDA)
  • Left main artery 
  • Left anterior descending (LAD)
  • Circumflex artery 

For additional points:

  • R marginal artery
  • L marginal artery
  • Diagonal branch of the LAD

Associate the leads of an ECG with the vessel distribution. 

 


Practice cases with pearls and pitfalls

Case 1 

Inf MI

Is this a STEMI?  What is the distribution? 

What is the next step in evaluating this MI and why?

Case 2

Post MI

Is this a STEMI?  What is the distribution? 

Case 3

L main STEMI

Is this a STEMI?  What is the distribution? 

Case 4

Inf-post MI

Is this a STEMI?  What is the distribution?


References:

Healio.com - Learn the heart ECG archive: www.healio.com/cardiology/learn-the-heart/ecg-review/ecg-archive