I am confused whether it is LCx or left main coronary artery or distal LAD

identify the culprit artery? I am confused whether it is LCx or left main coronary artery or distal LAD… This topic haunts me everytime

LAD- Diagonal branch

There is also associated AV block

Also elevation and I,avL and associated reciprocal changes.

There is ST elevation in V3 and V4 so It is a case of Anterior wall MI means it is due to occlusion of LAD. Now we should localise the lesion in LAD. We can see ST elevation in V1 so septum is involved and lesion is before S1 branch of LAD, again we can see ST elevation in lead 1, AVL means high lateral wall is involved means occlusion is before D1 also. So the oclusion is in LAD and before D1. And in this patient D1 branch is present before S1 like most of the people.

thank you so much! I understood it clearly.

Enough we have discussed and depending on the ecg can make modifications…abubakkers ans Is our way of looking at it