inferolateral myocardial infarct

Inferolateral Myocardial Infarction Description

An inferolateral myocardial infarct, also known as an inferior wall myocardial infarction, is a type of heart attack that affects the lower chambers (inferior wall) and outer walls (lateral wall) of the heart. This condition occurs when there is a blockage or narrowing of the coronary arteries that supply blood to these areas, leading to damage or death of the heart muscle.

Key Features

• Electrocardiographic (ECG) changes: Marked ST elevation in leads II, III, and aVF, with a "tombstone" appearance [1].
• Symptoms: Chest discomfort or pain, shortness of breath, and fatigue [6].
• Causes: Blockage or narrowing of the coronary arteries due to atherosclerosis (plaque buildup) [13].

Other Relevant Information

• Inferolateral myocardial infarction accounts for 40-50% of all myocardial infarctions [1].
• The prognosis is generally favorable, but certain associated features can indicate a worse outcome [1].
• Treatment involves improving blood flow to the heart muscle through medications and/or interventions such as angioplasty or bypass surgery [3].

References

[1] Inferior myocardial infarction (MI) accounts for 40-50% of all MIs. It generally has a more favourable prognosis than anterior myocardial infarction (in-hospital mortality only 2-9%), however certain associated features indicate a worse outcome ... Massive inferolateral STEMI: Marked ST elevation in II, III and aVF with a “tombstone ...

[3] Myocardial ischemia, also called cardiac ischemia, reduces the heart muscle's ability to pump blood. A sudden, severe blockage of one of the heart's artery can lead to a heart attack. Myocardial ischemia might also cause serious abnormal heart rhythms. Treatment for myocardial ischemia involves improving blood flow to the heart muscle.

[13] Causes of Inferior Myocardial Infarction: Inferior myocardial infarction is primarily caused by the blockage or narrowing of the coronary arteries that supply blood to the inferior wall of the heart. The common causes include: Coronary artery disease: Atherosclerosis, which involves the buildup of plaque in the coronary arteries, is the most ...

The differential diagnosis of an inferolateral myocardial infarct involves considering various conditions that can present with similar electrocardiographic (ECG) changes.

• Early Repolarization Pattern (ERPS): This is a common cause of ST segment elevation in the inferolateral leads, particularly in young individuals and those without a history of coronary artery disease. ERPS is characterized by a concave upward ST segment that blends with the T wave to form a dome-like shape [11].
• Inferolateral Myocardial Infarction: As mentioned earlier, this condition involves occlusion of the right coronary artery or left circumflex artery, leading to decreased perfusion in the inferolateral region of the myocardium. The ECG changes are similar to those seen in ERPS, but with additional signs such as ST segment depression in aVL and reciprocal ST segment elevation [11].
• Acute Pericarditis: This condition can also present with ST segment elevation in the inferolateral leads, although the ST segments tend to be more concave upward and may have a "saddleback" appearance. The ECG changes are often accompanied by chest pain and other symptoms of pericardial inflammation [8].
• Myocarditis: This condition involves inflammation of the myocardium and can present with various ECG abnormalities, including ST segment elevation in the inferolateral leads. However, the ECG changes tend to be more diffuse and may not be as localized as those seen in ERPS or inferolateral MI [8].

To differentiate between these conditions, clinicians should consider the following factors:

• Clinical history: A thorough review of the patient's medical history, including any symptoms or signs of coronary artery disease, pericardial inflammation, or myocardial injury.
• ECG findings: Careful examination of the ECG tracings to identify specific patterns and changes that are characteristic of each condition.
• Cardiac biomarkers: Measurement of cardiac troponins and other biomarkers to assess for evidence of myocardial injury or infarction.
• Imaging studies: Use of echocardiography, stress testing, or other imaging modalities to evaluate the extent and severity of any myocardial damage.

By considering these factors and using a combination of clinical judgment and diagnostic tests, clinicians can accurately diagnose inferolateral myocardial infarct and differentiate it from other conditions with similar ECG changes.