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| __NOTOC__
| | #redirect:[[Posterior myocardial infarction]] |
| {{ST elevation myocardial infarction}}
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| {{CMG}}
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| {{SK}} true posterior MI
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| ==Overview==
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| A posterior MI is a [[heart attack]] or cessation of blood flow to the [[heart muscle]] that involves the backside or posterior side of the heart. Rather than causing the traditional [[ST segment elevation]] characteristic of the electrocardiogram of many heart attacks (a "[[STEMI]]"), because the heart attack is on the opposite side of the heart, the ST segments are depressed in the anterior precordial leads rather than elevated.
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| ==Pathophysiology==
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| A posterior MI is due to occlusion of the [[left circumflex artery]].
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| ==EKG Examples of Posterior MI==
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| Shown below is an EKG with [[ST elevation]] in [[Electrocardiogram#Limb|II]], [[Electrocardiogram#Limb|III]], [[Electrocardiogram#Augmented limb|aVF]] (in [[Electrocardiogram#Limb|III]] > [[Electrocardiogram#Limb|II]]), [[ST depression]] in [[Electrocardiogram#Limb|I]], [[Electrocardiogram#Augmented limb|aVL]], [[Electrocardiogram#Precordial|V2]]. Tall R in [[Electrocardiogram#Precordial|V2]], otherwise normal QRS morphology. The findings are suggestive of acute posteroinferior MI.
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| [[Image:STEMI 3.jpg|center|800px]]
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| Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
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| Shown below is an EKG demonstrating changes during acute posterolateral MI depicting [[ST depression]] in [[precordial lead]]s [[Electrocardiogram#Precordial|V2]]-[[Electrocardiogram#Precordial|V6]].
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| [[Image:STEMI 5.jpg|center|800px]]
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| Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
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| ----
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| Shown below is an EKG with [[ST depression]] in [[Electrocardiogram#Precordial|V1]], [[Electrocardiogram#Precordial|V4]], [[tall R]] in [[Electrocardiogram#Precordial|V2]]. [[ST elevation]] in [[Electrocardiogram#Limb|II]], [[Electrocardiogram#Limb|III]], [[Electrocardiogram#Augmented limb|aVF]], [[Electrocardiogram#Precordial|V5]] and [[Electrocardiogram#Precordial|V6]].
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| [[Image:STEMI 6.jpg|center|800px]]
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| Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
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| Shown below is an EKG illustrating inferior-posterior myocardial infarction with [[complete AV block]] and [[ventricular escape beat|ventricular escape rhythm]] with [[RBBB]] pattern and left axis, followed by [[sinus rhythm]].
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| [[Image:STEMI 13.jpg|center|800px]]
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| Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
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| Shown below is an EKG demonstrating [[atrial fibrillation]] and inferior-posterior myocardial infarction.
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| [[Image:STEMI 20.jpg|center|800px]]
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| Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
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| Shown below is an EKG demonstrating inferior-posterior-lateral myocardial infarction with a nodal escape rhythm
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| [[Image:STEMI 21.jpg|center|800px]]
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| Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
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| Shown below is an EKG demonstrating atrial fibrillation with inferior-posterior-lateral myocardial infarction and incomplete [[right bundle branch block]]. Lead I shows ST depression, suggestive of right coronary artery involvement.
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| [[Image:STEMI 27.jpg|center|800px]]
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| Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
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| Shown below is an EKG demonstrating typical [[negative T waves]] post anterior myocardial infarction. This patient also shows [[QTc prolongation]]. Whether this has an effect on prognosis is debated. <ref name="pmid18019666">{{cite journal |author=Novotný T, Sisáková M, Floriánová A, ''et al'' |title=[QT dynamicity in risk stratification in patients after myocardial infarction] |language=Czech |journal=Vnitr Lek |volume=53 |issue=9 |pages=964–7 |year=2007 |month=September |pmid=18019666 |doi= |url=}}</ref><ref name="pmid15851335">{{cite journal |author=Jensen BT, Abildstrom SZ, Larroude CE, ''et al'' |title=QT dynamics in risk stratification after myocardial infarction |journal=Heart Rhythm |volume=2 |issue=4 |pages=357–64 |year=2005 |month=April |pmid=15851335 |doi=10.1016/j.hrthm.2004.12.028 |url=}}</ref><ref name="pmid12716101">{{cite journal |author=Chevalier P, Burri H, Adeleine P, ''et al'' |title=QT dynamicity and sudden death after myocardial infarction: results of a long-term follow-up study |journal=J. Cardiovasc. Electrophysiol. |volume=14 |issue=3 |pages=227–33 |year=2003 |month=March |pmid=12716101 |doi= |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1045-3873&date=2003&volume=14&issue=3&spage=227}}</ref>
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| [[Image:STEMI 28.png|center|800px]]
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| Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
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| Shown below is an EKG demonstrating ST elevation in leads II, III and aVF and ST depression in leads V1, V2 and V3 depicting a [[posterior MI]].
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| [[Image:Posterior MI patient.jpg|center|800px]]
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| ==References==
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| {{Reflist|2}}
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| [[Category:Disease]]
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| [[Category:Cardiology]]
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| [[Category:Ischemic heart diseases]]
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| [[Category:Intensive care medicine]]
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| [[Category:Emergency medicine]]
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| [[Category:Primary care]]
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| [[Category:Up-To-Date]]
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| [[Category:Up-To-Date cardiology]]
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| [[Category:Mature chapter]]
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| {{WH}}
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| {{WS}}
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| ==References==
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| {{Reflist|2}}
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