About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Inferior Myocardial Infarction on ECG
Introduction
An inferior myocardial infarction (MI) refers to a heart attack affecting the inferior (bottom) part of the heart, usually supplied by the right coronary artery (RCA) or sometimes the left circumflex artery (LCx).
Key ECG Features of Inferior MI:
- ST-segment elevation in leads II, III, and aVF (these leads reflect the inferior wall of the heart).
- Reciprocal ST-segment depression in leads I and aVL (suggesting a true ischemic event).
- Possible right ventricular involvement:
- If ST elevation is greater in lead III than in lead II, it suggests right ventricular infarction.
- Obtain right-sided chest leads (V4R, V5R, V6R) if right ventricular infarction is suspected.
- Bradycardia and heart blocks due to involvement of the AV node, which is often supplied by the RCA.
Clinical Significance
- Inferior MI often presents with nausea, vomiting, and vagal symptoms (slow heart rate and low blood pressure) rather than severe chest pain.
- Complications: May include hypotension, heart block, and right ventricular infarction, which require careful management.
- Treatment: Patients require immediate aspirin, P2Y12 inhibitors (e.g., clopidogrel), heparin, and most require urgent revascularization with PCI (percutaneous coronary intervention).
Conclusion
Recognizing an inferior MI on ECG is critical for early diagnosis and treatment, especially considering the potential for severe complications.
Source recommendations
1. American Heart Association Guidelines for Management of ST-Elevation Myocardial Infarction
- https://professional.heart.org/en/science-news/2021-acc-aha-scai-guideline-for-coronary-artery-revascularization
- https://www.ahajournals.org/doi/10.1161/cir.0b013e3182742cf6
- https://pubmed.ncbi.nlm.nih.gov/23256914/
- https://www.ahajournals.org/doi/10.1161/01.cir.0000134791.68010.fa
- https://www.sciencedirect.com/science/article/pii/S073510972106157X
2. European Society of Cardiology Guidelines for Acute Coronary Syndromes
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-Coronary-Syndromes-ACS-Guidelines
- https://academic.oup.com/eurheartj/article/44/38/3720/7243210
- https://pubmed.ncbi.nlm.nih.gov/37622654/
- https://academic.oup.com/eurheartj/article/42/14/1289/5898842
- https://pubmed.ncbi.nlm.nih.gov/32860058/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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