Dark Side of the Moon B W Art

Posterior myocardial infarction: the nighttime side of the moon

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• PMID: 17612703
• PMCID: PMC1847720

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Posterior myocardial infarction: the dark side of the moon

East O F van Gorselen  et al. Neth Center J. 2007 January .

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Abstract

The clinical presentation of posterior myocardial infarction is not ever piece of cake, not even for the cardiologist. In this article a lxx-year-one-time woman who presented with chest pain is described. The electrocardiogram at presentation showed marked ST-segment depression in leads V(1) to V(5) and slight ST-segment low in leads I and aVL. There was ST-segment pinnacle in the posterior leads Five(7) to 5(9). Pinnacle of specific cardiac enzymes confirmed the diagnosis of myocardial infarction. True posterior myocardial infarction is difficult to recognise considering the leads of the standard 12-lead electrocardiogram are not a direct representation of the surface area involved. Only with indirect changes in the precordial leads as such the diagnosis can be suspected. This review will highlight the electrocardiographic fine-tuned diagnosis of posterior myocardial infarction by using the posterior leads 5(7) to V(ix) leading to easier and faster recognition with consequences for handling and improved prognosis. (Neth Heart J 2007;xv:16-21.).

Figures

Figure one.

12-lead ECG on admission.

Figure 2.

Posterior leads V_viito V₉ on admission.

Figure 3.

ECG two days later on thrombolysis.

Figures 4 and 5.

Coronary angiography: correct anterior oblique view (left picture) and left inductive view (right pic), left coronary artery, showing a 90% stenosis of the circumflex artery (white pointer) and a lxx% stenosis in the left anterior descending (blackness arrow) artery just distal to a large diagonal branch.

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Source: https://pubmed.ncbi.nlm.nih.gov/17612703/

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