Inferior-septal myocardial infarction misdiagnosed as anterior-septal myocardial infarction: electrocardiographic, scintigraphic, and angiographic correlations.
- Author:
Ji-lin CHEN
1
;
Zuo-xiang HE
;
Zai-jia CHEN
;
Jin-qing YUAN
;
Yue-qin TIAN
;
Shu-bin QIAO
;
Rong-fang SHI
;
Yi-da TANG
;
Zong-lang LU
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Coronary Angiography; Diagnostic Errors; Female; Humans; Male; Middle Aged; Myocardial Infarction; diagnosis; diagnostic imaging; physiopathology; Radionuclide Imaging
- From: Chinese Medical Sciences Journal 2007;22(4):228-231
- CountryChina
- Language:English
-
Abstract:
OBJECTIVETo explore the infarct sites in patients with inferior wall acute myocardial infarction (AMI) concomitant with ST segment elevation in leads V1-V3 and leads V3R-V5R.
METHODSFive patients diagnosed as inferior, right ventricular, and anteroseptal walls AMI at admission were enrolled. Electrocardiographic data and results of isotope 99mTc-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging and coronary angiography (CAG) were analyzed.
RESULTSElectrocardiogram showed that ST segment significantly elevated in standard leads II, III, aVF, and leads V1-V3, V3R-V5R in all five patients. The magnitude of ST segment elevation was maximal in lead V1 and decreased gradually from lead V1 to V3 and from lead V1 to V3R-V5R. There was isotope 99mTc-MIBI myocardial perfusion imaging defect in inferior and basal inferior-septal walls. CAG showed that right coronary artery was infarct-related artery.
CONCLUSIONSThe diagnostic criteria for basal inferior-septal wall AMI can be formulated as follows: (1) ST segment elevates > or = 2 mm in lead V1 in the clinical setting of inferior wall AMI; (2) the magnitude of ST segment elevation is the tallest in lead V1 and decreases gradually from lead V1 to V3 and from lead V1 to V3R-V5R. With two conditions above, the basal inferior-septal wall AMI should be diagnosed.
