What is an inferior posterior infarct?
Clinical Significance of Posterior MI Posterior extension of an inferior or lateral infarct implies a much larger area of myocardial damage, with an increased risk of left ventricular dysfunction and death. Isolated posterior infarction is an indication for emergent coronary reperfusion.
How serious is an inferior infarct?
The mortality rate of an inferior wall MI is less than 10 percent. However, several complicating factors can lead to increased mortality, including right ventricular infarction, hypotension, bradycardia, heart block, and cardiogenic shock.
What does posterior infarct mean?
Posterior myocardial infarction occurs when the posterior coronary circulation becomes disrupted. The two main branches of the coronary circulation are the right coronary artery and the left main coronary artery.
What is an inferior infarct on ECG?
Inferior Wall ST Segment Elevation Myocardial Infarction (MI) ECG Review. An inferior wall MI — also known as IWMI, or inferior MI, or inferior ST segment elevation MI, or inferior STEMI — occurs when inferior myocardial tissue supplied by the right coronary artery, or RCA, is injured due to thrombosis of that vessel.
What is inferior posterior?
Inferior or caudal – away from the head; lower (example, the foot is part of the inferior extremity). Anterior or ventral – front (example, the kneecap is located on the anterior side of the leg). Posterior or dorsal – back (example, the shoulder blades are located on the posterior side of the body).
What part of the heart is affected by an inferior MI?
While inferior wall MIs traditionally have a good prognosis, there are a few factors that may increase mortality. Approximately 40% of inferior wall infarctions also involve the right ventricle. Right ventricular infarctions are very pre-load dependent, and nitrates may precipitate a drop in blood pressure.
What causes inferior infarct?
Inferior wall myocardial infarction (MI) occurs from a coronary artery occlusion with resultant decreased perfusion to that region of the myocardium. Unless there is timely treatment, this results in myocardial ischemia followed by infarction.
What does inferior infarct age undetermined mean?
If the finding on an ECG is “septal infarct, age undetermined,” it means that the patient possibly had a heart attack at an undetermined time in the past. A second test is typically taken to confirm the finding, because the results may instead be due to incorrect placement of electrodes on the chest during the exam.
What are the symptoms of posterior cerebral stroke?
Patients with posterior cerebral artery (PCA) infarcts present for neurologic evaluation with symptoms including the following:
- Acute vision loss.
- Confusion.
- New onset posterior cranium headache.
- Paresthesias.
- Limb weakness.
- Dizziness.
- Nausea.
- Memory loss.
When should you suspect posterior MI?
ST elevation in the posterior leads of a posterior ECG (leads V7-V9). Suspicion for a posterior MI must remain high, especially if inferior ST segment elevation is also present. ST segment elevation in the inferior leads (II, III and aVF) if an inferior MI is also present.
What is an infarct?
Infarction is tissue death or necrosis due to inadequate blood supply to the affected area. It may be caused by artery blockage, rupture, mechanical compression, or vasoconstriction. Infarction care is divided based on histopathology (white infarction and red infarction) and location (heart, brain, lung, etc.).
Can you recover from a posterior stroke?
Mortality associated with isolated posterior cerebral artery (PCA) stroke is low; therefore, the prognosis is generally good. Visual field deficits improve to varying degrees; however, they may be permanent and associated with morbidity.
What is the treatment for a posterior stroke?
Intravenous thrombolysis (IVT) is a standard treatment for both anterior circulation ischemic stroke (ACIS) and posterior circulation ischemic stroke (PCIS). Recombinant tissue plasminogen activator (rtPA, alteplase) was licensed for the first time in 1996 in North America for intravenous use within 3 h.
How is posterior MI diagnosed on ECG?
The ECG findings of an acute posterior wall MI include the following:
- ST segment depression (not elevation) in the septal and anterior precordial leads (V1-V4).
- A R/S wave ratio greater than 1 in leads V1 or V2.
- ST elevation in the posterior leads of a posterior ECG (leads V7-V9).
Is infarct a stroke?
Infarction or Ischaemic stroke are both names for a stroke caused by a blockage in a blood vessel in the brain. This is the most common type of stroke.
How common is posterior infarction?
Posterior infarction accompanies 15-20% of STEMIs, usually occurring in the context of an inferior or lateral infarction. Isolated posterior MI is less common (3-11% of infarcts). Posterior extension of an inferior or lateral infarct implies a much larger area of myocardial damage, with an increased risk of left ventricular dysfunction and death.
What is inferolateral myocardial infarction?
Inferolateral myocardial infarction ST segment elevation is seen in inferolateral leads (II, III, aVF, V5, V6) indicating inferolateral ST elevation myocardial infarction (STEMI). There is a discordance between the ST segment in aVL and V6 – there is ST segment depression in aVL while the ST segment is minimally elevated in V6.
What is isolated posterior infarction with STEMI?
Isolated posterior infarction is an indication for emergent coronary reperfusion. However, the lack of obvious ST elevation in this condition means that the diagnosis is often missed. Be vigilant for evidence of posterior MI in any patient with an inferior or lateral STEMI.
What is the prognosis of an inferior wall myocardial infarction?
Approximately 40 percent of myocardial infarctions involve the inferior wall. Traditionally, inferior MIs have a better prognosis than those in other regions, such as the anterior wall of the heart. The mortality rate of an inferior wall MI is less than 10 percent.