Objective To investigate relations of electrocardiography change in acute inferior wall myocardial infarction (IWAMI) with infarct-related coronary artery.

Methods 88 cases of acute inferior myocardial infarction (AIMI) patients were chosen from February 2006 to December 2013 in our hospital, and diagnosed by electrocardiogram, myocardial enzymes markers as well as coronary angiography (CAG), including 65 males, and 23 females, aged 40 to 78 years, mean age 64 ± 17 years old, They were admitted to hospital for coronary angiography after 1–2 weeks.

Results 88 cases of acute inferior wall myocardial infarction, II, III ST-segment elevation > 1 mm, and ST III / ST II > 1, the right coronary artery disease (62.5%), left circumflex artery lesions (37.5%); while the inferior wall AMI ST aVL >I, III > II suggested left circumflex artery occlusion, which accounted for 60.2% of the right coronary artery, left circumflex artery lesions accounted for 28.4%. 88 cases of acute inferior wall myocardial infarction undergoing coronary angiography: 36 cases of simple single inferior wall myocardial infarction (40.9%), 26 patients of which were right coronary artery (RCA) (72.2%), 10 cases of left circumflex artery (LCX) lesions (37.5%); inferior wall added posterior wall infarction in 24 cases (27.3%); inferior wall infarction added right ventricular in 20 cases (22.7%); inferior wall infarction added anterior wall infarction 8 cases (9.1%).

Conclusion ECG was significantly correlated with coronary occlusion in ST segment elevation acute inferior wall myocardial infarction. Cinical manifestations are identical with infarcted size.