Anterior Myocardial Infarction on ECG

Introduction

Anterior myocardial infarction (AMI) occurs when there is a blockage in the left anterior descending (LAD) artery, which supplies blood to the anterior wall of the left ventricle. This type of heart attack is often severe and requires immediate medical attention.

ECG Findings in Anterior Myocardial Infarction

Key Features:

  1. ST-segment elevation in leads V1–V6 (especially V3 and V4).
  2. Reciprocal ST-segment depression in inferior leads (II, III, aVF).
  3. Pathological Q waves may develop over time, indicating myocardial necrosis.
  4. T-wave inversion following ST-segment elevation, showing ischemic recovery.
  5. Loss of R-wave progression in precordial leads.

Clinical Implications and Management

  • Immediate reperfusion therapy (PCI or thrombolysis) is essential to restore blood flow.
  • Aspirin, P2Y12 inhibitors, and anticoagulation are standard treatment measures.
  • Beta-blockers, ACE inhibitors, and statins are used post-infarction for long-term management.
  • Complications include heart failure, arrhythmias, and cardiogenic shock, requiring intensive care.

Conclusion

Anterior myocardial infarction is a critical cardiac emergency. Recognizing early ECG changes and initiating rapid treatment saves lives. Regular follow-up and lifestyle modifications are key to preventing further events.

Source recommendations

1. American Heart Association Guidelines for the Management of ST-Elevation Myocardial Infarction

  1. https://professional.heart.org/en/science-news/2021-acc-aha-scai-guideline-for-coronary-artery-revascularization
  2. https://www.ahajournals.org/doi/10.1161/cir.0b013e3182742cf6
  3. https://pubmed.ncbi.nlm.nih.gov/23256914/
  4. https://www.ahajournals.org/doi/10.1161/01.cir.0000134791.68010.fa
  5. https://www.sciencedirect.com/science/article/pii/S073510972106157X

2. European Society of Cardiology Guidelines for Acute Coronary Syndromes

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-Coronary-Syndromes-ACS-Guidelines
  2. https://academic.oup.com/eurheartj/article/44/38/3720/7243210
  3. https://pubmed.ncbi.nlm.nih.gov/37622654/
  4. https://academic.oup.com/eurheartj/article/42/14/1289/5898842
  5. https://pubmed.ncbi.nlm.nih.gov/32860058/

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