Posterior MI: Difference between revisions

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__NOTOC__
#redirect:[[Posterior myocardial infarction]]
{{ST elevation myocardial infarction}}
{{CMG}}
{{SK}} true posterior MI
 
==Overview==
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.
 
==Pathophysiology==
A posterior MI is due to occlusion of the [[left circumflex artery]].
 
==EKG Examples of Posterior MI==
 
Shown below is an EKG demonstrating changes during acute posterolateral MI depicting [[ST depression]] in [[precordial lead]]s [[Electrocardiogram#Precordial|V2]]-[[Electrocardiogram#Precordial|V6]].
 
[[Image:STEMI 5.jpg|center|800px]]
 
Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
 
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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]].
[[Image:STEMI 6.jpg|center|800px]]
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]].
[[Image:STEMI 13.jpg|center|800px]]
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.
[[Image:STEMI 20.jpg|center|800px]]
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
[[Image:STEMI 21.jpg|center|800px]]
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.
[[Image:STEMI 27.jpg|center|800px]]
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>
[[Image:STEMI 28.png|center|800px]]
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]].
[[Image:Posterior MI patient.jpg|center|800px]]
 
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==References==
{{Reflist|2}}
 
[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Ischemic heart diseases]]
[[Category:Intensive care medicine]]
[[Category:Emergency medicine]]
[[Category:Primary care]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]
[[Category:Mature chapter]]
 
{{WH}}
{{WS}}
 
 
==References==
{{Reflist|2}}

Latest revision as of 20:54, 11 March 2014