Anatomy - Occlusion in the LAD distal to the first septal branch and proximal to the first diagonal

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An occlusion in the LAD between the first septal branch and the first diagonal branch does not result in ischemia of the superior region of the left ventricle. In this case, the ischemia vector points to the left and superiorly. Consequently, the amplitude of ST elevation is greatest in lead aVL. Also this occlusion results in ST elevation in lead I and ST depression in lead III (since the positive pole of lead III is approximately opposite the positive pole of lead aVL).

 

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