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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.
Lateral Myocardial Infarction (MI) on ECG
Introduction
Lateral Myocardial Infarction (MI) occurs when the blood supply to the lateral wall of the heart is blocked, most commonly due to a blockage in the left circumflex (LCx) artery or diagonal branches of the left anterior descending (LAD) artery.
ECG Features of Lateral MI
1. ST-Segment Elevation
Seen in leads I, aVL, V5, and V6.
2. Reciprocal Changes
ST-segment depression in leads III and aVF, indicating opposing electrical activity from inferior leads.
3. Q Waves (if present)
In I, aVL, V5, V6, suggestive of a completed infarction.
4. T-wave Inversion (later stage)
Can develop in the affected leads as the infarction evolves.
Differential Diagnosis
- Pericarditis: Diffuse ST elevation, usually without reciprocal ST depression.
- Early Repolarization: Benign, especially in young individuals.
- Left Ventricular Hypertrophy (LVH): Can mimic ST elevation in lateral leads.
Management of Lateral MI
Lateral MI requires urgent medical intervention as it can lead to complications such as heart failure or arrhythmias.
Immediate Treatment:
- Aspirin + P2Y12 inhibitor (e.g., Clopidogrel, Ticagrelor).
- Anticoagulation (e.g., Heparin).
- Oxygen (if hypoxic).
- Reperfusion therapy:
- Primary PCI (preferred if available within 90 minutes).
- Fibrinolysis (if PCI is unavailable).
Conclusion
Recognizing lateral MI on ECG is vital for early intervention and preventing complications. If you suspect a lateral MI, seek immediate medical attention.
Source recommendations
1. American College of Cardiology/American Heart Association (ACC/AHA) STEMI Guidelines
- https://www.acc.org/Guidelines
- https://www.ahajournals.org/doi/10.1161/01.cir.0000134791.68010.fa
- https://www.jacc.org/doi/10.1016/j.jacc.2021.09.005
- https://www.ahajournals.org/doi/10.1161/cir.0b013e3182742cf6
- https://pubmed.ncbi.nlm.nih.gov/23256914/
2. European Society of Cardiology (ESC) Guidelines for the Management of 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://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/08/29/14/01/2023-esc-guidelines-acs-esc-2023
- https://pubmed.ncbi.nlm.nih.gov/26320110/
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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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