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[True posterior infarction diagnosis. Report of three cases]

Fernando Pineda1, Bruno Dighero2, Jorge Meruane2

  • 1Cardiología y Hemodinamia, Clínica las Condes, Santiago, Chile.

Revista Medica De Chile
|March 23, 2022
PubMed

Insights

ST-elevation myocardial infarction (STEMI) requires prompt reperfusion. True Posterior Infarction (TPI) diagnosis is challenging using standard EKGs, necessitating posterior leads or mirror imaging for accurate identification and timely treatment.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Emergency Medicine

Background:

  • ST-segment elevation myocardial infarction (STEMI) demands rapid reperfusion.
  • Accurate electrocardiogram (EKG) interpretation is critical for timely therapeutic decisions in acute coronary syndromes.

Observation:

  • Three cases of True Posterior Infarction (TPI) presented diagnostic challenges.
  • The standard 12-lead EKG was insufficient for diagnosing these TPI cases.

Findings:

  • Posterior leads on an EKG can aid in diagnosing TPI.
  • Observing inverted leads V1-V3 on a standard EKG may suggest posterior infarction.

Implications:

  • Early identification of TPI is crucial for initiating appropriate reperfusion therapy.
  • Integrating posterior leads or mirror imaging into routine EKG interpretation can improve TPI diagnosis.
  • Enhanced EKG diagnostic strategies can improve outcomes for patients with posterior myocardial infarction.

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