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Algorithm of Tierala et al for Predicting the Culprit Artery in Acute Inferior ST-Elevation Myocardial Infarction (STEMI)

Purpose: To determine the culprit artery for an acute inferior ST-elevation myocardial infarction (STEMI) using the algorithm of Tierala et al.

Description

Tierala et al developed an algorithm for identifying the culprit artery in acute inferior ST-segement elevation myocardial infarction (STEMI). The authors are from Helsinki University Central Hospital (Finland), Tampere University Hospital (Finland) and Procardia Medical Center (Israel).


Patient selection: ST elevation in at least 2 of II, III and avF.

 

Features of left circumflex artery (LCx) as culprit - one of the following:

(1) ST deviation in lead II >= ST deviation in lead III

(3) (ST deviation in lead II < ST deviation in lead III) AND (ST not elevated in V1) AND (ST not isoelectric in V1 and ST not depressed in V2) AND (ST depression in aVR >= ST depression in aVL)

 

Features of right coronary artery as culprit - one of the following:

(1) (ST deviation in lead II < ST deviation in lead III) AND (ST elevation in V1)

(2) (ST deviation in lead II < ST deviation in lead III) AND (isolectric ST in V1) AND (ST depression in V2)

(3) (ST deviation in lead II < ST deviation in lead III) AND NOT(1 OR 2) AND (ST depression in aVR < ST depression in aVL)


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Specialty

Objective

ICD-10