الفهرس 
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Abstract
Introduction: Lead aVR, an augmented unipolar limb lead, was constructed to obtain specific information from the right upper portion of the heart, including the outflow tract of the right ventricle and the basal portion of the inter-ventricular septum. However, lead aVR has been long neglected until recent years. Aim of the Work: to evaluate the diagnostic value of ST segment elevation in lead aVR in acute coronary syndrome patients. Subject and Methods: A descriptive study was conducted on 40 patients with ST segment elevation more than 1 mm in lead aVR admitted to CCU presenting with acute coronary syndrome as a study group in addition to 40 patients with acute coronary syndrome without ST segment elevation in lead aVR as a control group. Results: The current study revealed that the majority of patients among the study group is diagnosed as multi vessel disease (MVD) for CABG, while the majority of the control group had single vessel PCI, with statistical significant difference. Conclusion: The current study showed that ST segment elevation in lead aVR in the setting of acute coronary syndrome had an important diagnostic role , as it found that patients with ST segment elevation in lead aVR were more associated with multi vessel disease affection and were recommended for CABG more than patient without ST segment elevation in lead aVR. Recommendations: Patients with acute coronary syndrome who have ST segment elevation in lead aVR more than 1 mm should receive more intensive care and early referral to intensive treatment including revascularization.
Key words: lead aVR, ST segment elevation, acute coronary syndrome, coronary care unit