In conclusion; specific abnormal findings on ECGs may provide clues to the diagnosis and according to previous studies (3, 4) for risk stratification of PE in patients presenting with chest pain, dyspnea, or both; however, the present case illustrates the rare and interesting association of PE with ST-segment elevation in the aVR lead
. Therefore, we recommend that physicians consider the presence of PE in patients with chest pain or dyspnea, even when ST-segment elevation is present in aVR lead
In most patients there was a ST elevation of 1 to 2 mm in the aVR lead, persisting from the first ECG until the preprocedural ECG was performed and angiographic evidence of an occluded left anterior descending coronary artery (LAD) was obtained.
hypothesized that patients with such pattern have a very extensive transmural ischemic area of infarction that generates only little current which is not sufficient to travel toward the precordial leads but can go toward the aVR lead .
Value of the aVR lead
in differential diagnosis of atrioventricular nodal reentrant tachycardia.
They are: ST segment elevation in aVR lead
indicating left main coronary artery stenosis, the left bundle branch block in myocardial infarction, and posterior myocardial infarction [5, 6].