Table of Contents
Which ECG leads show inferior MI?
12-lead electrocardiogram (ECG) demonstrating evidence of inferior myocardial infarction (MI). ST-elevation is seen in leads II, III and aVF. Reciprocal changes can be seen in leads I, aVL, V2 and V3. There is also some ST-elevation in leads V5 and V6.
Which ECG looks at the inferior wall?
Inferior Wall ST Segment Elevation Myocardial Infarction (MI) ECG Review. An inferior wall MI — also known as IWMI, or inferior MI, or inferior ST segment elevation MI, or inferior STEMI — occurs when inferior myocardial tissue supplied by the right coronary artery, or RCA, is injured due to thrombosis of that vessel.
Which leads are inferior MI?
Inferior STEMI:
- ST elevation in II, III and aVF.
- Q-wave formation in III and aVF.
- Reciprocal ST depression and T wave inversion in aVL.
- ST elevation in lead II = lead III and absent reciprocal change in lead I (isoelectric ST segment) suggests a left circumflex artery occlusion.
How can you tell inferior MI?
Symptoms include chest pain, heaviness or pressure and shortness of breath, and diaphoresis with radiation to the jaw or arms. There are often other symptoms such as fatigue, lightheadedness, or nausea. On physical exam, particular attention should be given to the heart rate since bradycardia and heart block may occur.
What is inferior MI?
Inferior wall myocardial infarction (MI) occurs from a coronary artery occlusion with resultant decreased perfusion to that region of the myocardium. Unless there is timely treatment, this results in myocardial ischemia followed by infarction.
When a patient presents with an inferior wall MI What other area of the heart is at risk?
While inferior wall MIs traditionally have a good prognosis, there are a few factors that may increase mortality. Approximately 40% of inferior wall infarctions also involve the right ventricle. Right ventricular infarctions are very pre-load dependent, and nitrates may precipitate a drop in blood pressure.
What does MI look like on ECG?
The ECG findings of an acute anterior myocardial infarction wall include: ST segment elevation in the anterior leads (V3 and V4) at the J point and sometimes in the septal or lateral leads, depending on the extent of the MI. This ST segment elevation is concave downward and frequently overwhelms the T wave.
What is an inferior wall MI?
Where is inferior MI?
Which heart block is associated with inferior wall MI?
A high degree heart block, defined as a second or third-degree block, is seen in 19% of patients with acute inferior wall MI. The amount of collateral circulation to the AV impacts the rate of heart blocks.
How do you identify right ventricular MI?
Diagnosis is confirmed by the presence of ST elevation in the right-sided leads (V3R-V6R)
- V1 is the only standard ECG lead that looks directly at the right ventricle.
- Lead III is more rightward facing than lead II and hence more sensitive to the injury current produced by the right ventricle.
What is inferior myocardial infarction?
What does inferior MI mean?
An inferior myocardial infarction (MI) is a heart attack or cessation of blood flow to the heart muscle that involves the inferior side of the heart. Inferior MI results from the total occlusion of either the right coronary artery in 85% of the cases or the left circumflex in 15% of the cases.
Is inferior MI on right ventricle?
Acute myocardial infarction (MI) involving only the right ventricle is an uncommon event. More often, right ventricular MI (RVMI) is associated with acute ST-elevation MI of the inferior wall of the left ventricle and occurs in 30 to 50 percent of such cases [1-6].
Which artery is blocked in inferior wall MI?
Acute inferior wall myocardial infarction is usually due to occlusion of the RCA and is rarely due to occlusion of LCX.
What is an inferior wall?
Inferior wall myocardial infarctions are due to ischemia and infarction to the inferior region of the heart. In 80% of patients, the inferior wall of the heart is supplied by the right coronary artery via the posterior descending artery (PDA).
Which electrocardiogram leads reflect the inferior wall?
aVL is the only lead truly reciprocal to the inferior wall, as it is the only lead facing the superior part of the ventricle. It is thus a sensitive marker for inferior infarction In patient cohorts with inferior occlusion myocardial infarction (OMI), ST depression in aVL has been shown to be more prevalent than STE in inferior leads
How serious is an inferior wall infarction?
Traditionally, inferior MIs have a better prognosis than those in other regions, such as the anterior wall of the heart. The mortality rate of an inferior wall MI is less than 10%. However, several complicating factors that increase mortality, including right ventricular infarction, hypotension, bradycardia heart block, and cardiogenic shock.[1][2][3]
Is old inferior wall infarct dangerous?
While inferior wall MIs traditionally have a good prognosis, there are a few factors that may increase mortality. Approximately 40% of inferior wall infarctions also involve the right ventricle. Right ventricular infarctions are very pre-load dependent, and nitrates may precipitate a drop in blood pressure.