lateral myocardial infarction

Lateral Myocardial Infarction (MI) Description

A lateral myocardial infarction (MI) is a type of heart attack that affects the outer wall of the left ventricle, specifically the lateral side. This condition occurs when there is a blockage or reduction in blood flow to this area of the heart muscle, leading to damage or death of the affected tissue.

Characteristics

• Lateral MI typically involves the inferior side of the heart.
• Infarction of the lateral wall usually occurs as part of a larger territory infarction, such as anterolateral STEMI.
• Isolated lateral STEMI is less common but may be produced by occlusion of smaller branch arteries that supply the lateral wall.

Causes

• Lateral MI arises from acute atherosclerotic plaque rupture with subsequent thrombus formation in the left circumflex (LCx) coronary artery or one of its branches.
• This condition can also result from extensive anterolateral wall involvement due to blockage of the left anterior descending (LAD) coronary artery.

Symptoms

• Lateral MI symptoms may be subtle and similar to those experienced during other types of heart attacks, such as chest pain or discomfort.
• However, some patients with lateral MI may exhibit specific ECG changes in the lateral leads.

The description of a lateral myocardial infarction is characterized by its location on the outer wall of the left ventricle, typically involving the inferior side of the heart. This condition often occurs as part of a larger territory infarction and can result from blockage or reduction in blood flow to the affected area.

References:

• [1] Lateral and posterior walls form the left ventricular free wall, a common site for free-wall rupture (FWR) post-myocardial infarction.
• [2] A lateral myocardial infarction (MI) is a heart attack or cessation of blood flow to the heart muscle that involves the inferior side of the heart.
• [11] Like other acute myocardial infarctions, isolated lateral wall myocardial infarction (LMI) arises from acute atherosclerotic plaque rupture with subsequent thrombus formation in the left circumflex (LCx) coronary artery or one of its branches.

Lateral myocardial infarction (MI) is a type of heart attack that affects the lateral wall of the left ventricle. Diagnosing lateral MI can be challenging, but several diagnostic tests can help confirm the diagnosis.

Electrocardiogram (ECG): An ECG is a crucial test in diagnosing lateral MI. According to search result [3], a STEMI (ST-Elevation Myocardial Infarction) is a type of myocardial infarction that causes a distinct pattern on an electrocardiogram (ECG). However, the ECG findings for lateral MI may be more subtle and can include ST-segment elevation or depression in leads I, aVL, V5, and V6 [2].

Cardiac Biomarkers: Elevated levels of cardiac biomarkers such as troponin and CK-MB can indicate myocardial damage. Search result [2] states that diagnostic tests such as electrocardiography (ECG), cardiac biomarkers, and imaging studies are used to assess the severity and extent of myocardial damage.

Imaging Studies: Imaging studies such as echocardiography, radionuclide ventriculography, or cardiac MRI can help visualize the affected area of the heart. Search result [9] mentions the importance of serial electrocardiograms in diagnosing lateral MI, which may include imaging studies to confirm the diagnosis.

Physical Exam and EKG: A physical exam and EKG (electrocardiogram) can also be used to diagnose myocardial infarct, including lateral MI. Search result [8] states that a physical exam and EKG (plus blood test) are used to diagnose myocardial infarct via.

It's worth noting that the diagnosis of lateral MI is often based on a combination of clinical presentation, ECG findings, and imaging studies. A thorough evaluation by a healthcare professional is necessary to confirm the diagnosis.

References: [2] OJ Mechanic · 2023 · Cited by 213 [3] [8] [9] GS Reeder · Cited by 23

Lateral myocardial infarction (LMI) can be challenging to diagnose due to its non-specific presentation. However, there are several conditions that need to be ruled out in the differential diagnosis of LMI.

Causes of Non-Ischemic ST Segment Elevation

According to a clinical review by EC de Bliek [6], the following conditions can cause non-ischemic ST segment elevation and should be considered in the differential diagnosis of LMI:

• Early Repolarization: This is a benign condition characterized by ST segment elevation in leads V2-V3.
• Pericarditis: Inflammation of the pericardium can cause ST segment elevation, especially in the anterior leads.
• Myocarditis: Inflammation of the myocardium can also cause ST segment elevation and should be considered in the differential diagnosis.

Other Conditions to Consider

In addition to these conditions, other factors that may mimic LMI include:

• Lateral Extension of an Anterior MI: As mentioned in search result 2, lateral extension of an anterior MI indicates a larger territory of myocardium at risk with consequent worse prognosis.
• ST-Segment Elevation Myocardial Infarction (STEMI): STEMI is characterized by ST segment elevation in two or more contiguous leads and should be considered in the differential diagnosis.

Diagnostic Approach

The diagnosis of LMI is typically made through a combination of electrocardiography (ECG) and biomarkers. Treatment for LMI may include antiplatelets, anticoagulants, nitrates, beta-blockers, and other medications as per search result 4.

References:

[2] Oct 8, 2024 — Lateral extension of an anterior, inferior or posterior MI indicates a larger territory of myocardium at risk with consequent worse prognosis. [3] by D Ludhwani · 2024 · Cited by 9 — LMI presents like other types of myocardial infarction. The condition is often detected through lateral electrocardiogram (ECG) lead changes; ... [4] Diagnosis is by electrocardiography (ECG) and the presence or absence of biomarkers. Treatment is with antiplatelets, anticoagulants, nitrates, beta-blockers, ...