Abstract

LOMELI ESTRADA, Catalina et al. Left posterolateral extensive myocardial infarct: An electroanatomical comparison. Arch. Cardiol. Méx. [online]. 2008, vol.78, n.3, pp.338-343. ISSN 1665-1731.

A complete ECG thoracic circle allows exploring some heart structures not explored by the conventional electrocardiogram. It provides a direct indication on the location of the damaged myocardium. In fact, posterolateral infarctions can be limited to the inferior third of the left ventricle or can cover the entire free left ventricular wall from the base up to the heart apex and can be univentricular or biventricular. On the other side, the unipolar thoracic leads and the high abdominal leads MD, ME, Ml show the evolution of the signs of injury, characteristic of the acute stage of infarction, toward necrosis. We present the example of a 61-year-old man, whose ECG shows signs of subepicardial or transmural injury and of necrosis in the low precordial leads V₅ and V₆, as well as in the high left posterior leads V₈ and V₉. This fact suggests the presence of an acute extensive myocardial infarction extending from the base to the heart apex. Moreover, the moderate elevation of the RS-T segment from to V_9R to V_7R indicates the presence of subepicardial injury in the high posterior regions of the right ventricular wall. These electrocardiographic data were confirmed by the radioactive isotope study and, definitively, by the anatomical findings.

Keywords : Left extensive postero-lateral infarction; Postero-lateral biventricular infarction; Electrocardiographic thoracic circle.

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