About-Cardio
-
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 Wall Myocardial Infarction (IWMI) on ECG
Introduction
Inferior Wall Myocardial Infarction (IWMI) refers to a heart attack involving the inferior (lower) part of the heart, typically supplied by the right coronary artery (RCA) or, in some cases, the left circumflex artery (LCx). ECG plays a crucial role in its diagnosis.
ECG Changes in IWMI
Key Features:
- ST-segment Elevation:
- Found in leads II, III, and aVF, confirming myocardial injury in the inferior wall.
- Reciprocal ST-segment Depression:
- Typically seen in leads I and aVL, indicating ischemic changes in the opposing regions.
- Additional Considerations:
- Right Ventricular Involvement: If the RCA is affected proximally, ST elevation might be present in lead V1 or V4R (right-sided ECG leads).
- Posterior Involvement: ST depression in V1-V3 suggests a posterior infarction, often requiring confirmation with posterior leads (V7-V9).
Clinical Importance
- Bradycardia and Hypotension Risk: As the RCA often supplies the sinoatrial (SA) and atrioventricular (AV) nodes, patients might develop bradycardia or even heart block.
- Treatment Considerations:
- Avoid nitroglycerin in patients with suspected right ventricular infarction, as it can worsen hypotension.
- Fluid resuscitation may be needed if there is significant hypotension due to RV infarction.
- Reperfusion therapy (PCI or fibrinolysis) should be initiated promptly.
Conclusion
Timely recognition of IWMI using ECG is critical for appropriate management. Understanding the ECG changes and potential complications can help guide immediate treatment and improve patient outcomes.
Source recommendations
1. American Heart Association Guidelines for the 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 the Management of Acute Coronary Syndromes in Patients Presenting with ST-Segment Elevation
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-Coronary-Syndromes-ACS-Guidelines
- https://pubmed.ncbi.nlm.nih.gov/21873419/
- https://academic.oup.com/eurheartj/article/42/14/1289/5898842
- https://pubmed.ncbi.nlm.nih.gov/26320110/
- https://academic.oup.com/eurheartj/article/39/2/119/4095042
-
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!
Our advantages:
Best practices from USA, EU and Japan
Our answers to your questions are based on the clinical recommendations of countries with the most developed healthcare systems in the field of cardiology in the USA, the EU and Japan.
Always up-to-date information
On a daily basis, we monitor for you all new scientific research publications in leading scientific journals on medical issues of interest to you.
We monitor all innovations and changes in the field of cardiac disease treatment on a daily basis.
We monitor all innovations and changes in the field of cardiac disease treatment on a daily basis.
Get second opinion
Here you can learn everything that even your doctor may not know about cardiology (if he does not speak English and he does not read 117 leading medical journals on cardiology every month).
The most comprehensive and up-to-date collection of free cardiology materials
Our website contains the most comprehensive and up-to-date collection of free cardiology materials in your country.
Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.
Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.