Acute Anterolateral and Old Inferior Infarction

Report:

Sinus rhythm 74/min

VEB

RAA + LAA

Left axis deviation -35o

Old inferior infarction

Acute anterolateral infarction

Comment:

There is some slight ST elevation in the high lateral leads and marked one in V4-6 with reciprocal changes in V1-2. The inferior leads also show some ST elevation, but their pathological Q waves are already present, reflecting a prior (known) inferior MI. The trace could in all fairness be reported as acute inferolateral MI.

The next day (Fig 46a) the ST elevation spread to involve V3 and V1 remained the sole lead with reciprocal ST depression. Tachycardia 118/min reflected new LV failure. The patient, very old, with previous and current infarctions and pulmonary œdema, was thought to have bleak outlook and was treated conservatively.

He recovered and was quite well one year later. Those who attain his age are good material.

46a. Sinus tachycardia reflecting LV failure.

47. 49 year old man with chest pain and hypotension.

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