Anterior and Inferior Infarction
Report:
Sinus rhythm 95/min
Left axis deviation -40o
Borderline low voltage in frontal leads
Old inferior infarction
Anterior infarction, age indeterminate
Comment:
One cannot add âconsistent with ventricular aneurysmâ without knowing the history. But of course it is: months after the MI there is persistent ST segment elevation in V1-5. Most LV aneurysms are anterior; some are basal. There is no ST segment evidence in this case for inferior or posterior aneurysm. In Casualty, the best way of distinguishing acute anterior infarction from aneurysmal ST elevation is to average T/QRS ratio in V1-4, with cutoff for acute infarction at > 0.2278. In this case it is about 0.05.
The combination of inferior and anterior Q waves may suggest apical aneurysm, but in this case the aneurysm involved the anterior wall and some of the septum (most of them do)79.
110. 83 year old man on routine Outpatiens visit.
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