Acute Lateral Infarction
Report:
Sinus rhythm 95/min
Acute lateral infarction
Comment:
There is an obvious acute (with upright T waves) ST segment elevation in the (high) lateral leads 1 and aVL with reciprocal changes in the inferior leads. Lead 2 shows only slight depression because it is, arithmetically, lead 1 + lead 3.
The precordial T waves are suspiciously plump and upright in V2 through V6; one could call this an anterior, rather than lateral, infarction. There is no certainty, however. It is best to keep the reports within descriptive, established, conventional limits. Lateral, as mentioned earlier, does not mean LV free wall, anyway.
The patient was in pulmonary Ådema and shock, supported by mechanical ventilation and inotropes. She had advanced triple vessel disease, but underwent PTCA and stenting to the LAD artery only, a recognised but still debated strategy in emergencies64. Some anterior wall may have been salvaged, since the next dayâs ECG (Fig 88a) failed to show any evolution of the precordial changes. It did show, however, voltage loss and prognostically unfavourable right axis deviation65, but no lateral Q waves.
88a. Morphology of LPHB in the frontal leads, but with reduced rather than augmented magnitude: lateral infarction. R loss is equivalent to Q waves in this context.
89. 74 year old lady with chest pain.
89a. Same patient, 24 hours later.
89b. One hour after recording in 89b.
89c. Another 24 hours later.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and its records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.