EKG Basics and Interpretation - part 6 pptx

Inferior Family of MI´s• Inferior MI: Q waves and evolving ST-T changes in leads II, III, aVF • True posterior MI: ECG changes are seen in anterior precordial leads V1-3, but are the mir

Evolving MI

• Normal ECG prior to MI

• Hyperacute T wave - increased T wave

amplitude and width

• Marked ST elevation with hyperacute T wave changes (transmural injury)

• Pathologic Q waves, less ST elevation,

terminal T wave inversion (necrosis)

• Pathologic Q waves, T wave inversion

(necrosis and fibrosis)

• Pathologic Q waves, upright T waves

(fibrosis)

Inferior Family of MI´s

• Inferior MI: Q waves and evolving ST-T

changes in leads II, III, aVF

• True posterior MI: ECG changes are seen in anterior precordial leads V1-3, but are the

mirror image of an anteroseptal MI Often

seen with inferior MI

• Right Ventricular MI (only seen with proximal right coronary occlusion) ECG findings

usually require additional leads on right chest

Inferior MI

Inferoposterior MI

Right Ventricular MI

Anterior Family of MI´s

• Anteroseptal: Q, QS, or qrS complexes

in leads V1-V3 (V4), ST changes

• Anterior MI (similar changes, but usually V1 is spared; if V4-6 involved call it

"anterolateral")

• High Lateral MI (typical MI features

seen in leads I and/or aVL)

Anteroseptal MI

Anterolateral MI

Lateral MI

MI and LBBB

• Often a difficult ECG diagnosis because

in LBBB the right ventricle is activated first and left ventricular infarct Q waves may not appear at the beginning of the QRS complex