STEMI Diagnosis and Management MCQ — NEET PG Practice Question | NEETPGAI
STEMI Diagnosis and Management
easy
stethoscope Medicine
A 58-year-old man with a 20-year history of smoking and hypertension presents with acute anterior wall ST-elevation myocardial infarction. Which is the most common coronary artery involved in anterior wall STEMI?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Left main coronary artery
Explanation
Coronary Artery Distribution in STEMI
Key Point
The left anterior descending (LAD) artery is the most common vessel involved in acute myocardial infarction overall, and specifically causes anterior wall STEMI in the majority of cases.
Anatomical Basis
The LAD supplies:
Anterior wall of the left ventricle
Anterior two-thirds of the interventricular septum
Diagonal branches to the lateral wall
STEMI Location and Culprit Vessel Correlation
Table
STEMI Location
Most Common Culprit Artery
Frequency
Anterior wall
LAD
40–50%
Inferior wall
RCA (80%) or LCx (20%)
30–40%
Posterior wall
RCA or LCx
5–10%
Right ventricular
RCA (proximal)
3–5%
High-YieldNEET PG
LAD occlusion is the most common cause of acute MI death because it supplies the largest territory of myocardium and the conduction system.
Clinical Pearl
Anterior STEMI (ST elevation in V1–V4) indicates LAD occlusion proximal to the first diagonal branch. Proximal LAD occlusion carries the worst prognosis due to extensive myocardial necrosis and high risk of cardiogenic shock and conduction abnormalities.
Mnemonic
LAD = Largest territory, Lethal if occluded — Remember that LAD is responsible for ~50% of all acute MIs.
Why LAD is Most Common
1.
Largest coronary vessel by diameter and territory supplied
2.
Atherosclerosis burden is highest in LAD
3.
Most frequent site of plaque rupture and thrombosis
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