In patients with a posteroinferior acute myocardial infarction and both ST depression (in lead VI or V2) and ST elevation in the inferior leads, it is difficult to differentiate a left circumflex artery occlusion from a right coronary artery occlusion. Furthermore, there is no useful method to identify the obstruction site in the left circumflex artery. In a study of 52 patients with single-vessel left circumflex artery disease, ST elevation in V6 was found to be a useful indicator for left circumflex artery occlusion in such patients. Furthermore, the sum of the ST changes in leads aVF and V2 is useful for identifying the occluded site in the left circumflex artery.
(Internal Medicine 35: 261-265, 1996)