Isolated Posterior Infarction

Report:

Sinus rhythm 68/min

Old posterior infarction

Comment:

There is, in V1, a dominant R wave (R/S > 1.0) with upright T wave and absence of other causes of dominant R there (RBBB, WPW ‘A’, RVH). True posterior infarct.

The tracing is otherwise normal. In a younger subject it could indeed be a normal variant or reflect cardiac dextroposition.

The posterior infarct was later masked by RBBB (68a) developed when the patient had CABGs for post-infarct angina. The monophasic R in V1 may have something to do with previous infarction – especially with no obvious hemiblock), but some RBBBs look like that anyway.

68a.

69. Ventilated 43 year old man with massive intracranial hæmorrhage from a known AV malformation.

If you have any suggestions for or feedback on this report, please let us know.