Myocardial infarction anterior-wall

It is important to obtain a baseline EKG and cardiac enzymes to evaluate the possibility of an acute myocardial infarction. The short-term (2-4 weeks) stroke risk after acute myocardial infarction (AMI) is 2.5%. Stroke is usually an early (within 14 days) complication of AMI and is more common in anterior wall (4—12%) than in inferior wall infarction (1%). Approximately 40% of patients with an anterior wall myocardial infarction develop left ventricular thrombus. 

Sugiura T, Iwasaka T, Hasegawa T, et al. Factors associated with persistent and transient fascicular blocks in anterior wall acute myocardial infarction. Am. J. Cardiol. 1989 63 784-7. 

Lunde KSS, Aakhus S, Arnesen H, Forfang K. Intracoronary injections of autologous mononuclear bone marrow cells in acute anterior wall myocardial infarction the ASTAMI randomized controlled trial, In Scientific Sessions of the American Heart Association 2005, Internet communication, 2006,... 

Y. Nakagawa, H. Ito, M. Kitakaze, H. Kusuoka, M. Hori, T. Kuzuya, Y. Higashino, K. Fujii, T. Minami-no, Effect of angina pectoris on myocardial protection in patients with reperfused anterior wall myocardial infarction retrospective clinical evidence of preconditioning , J Am Coll Cardiol 25, 1076-1083 (1995). 

M. Ishihara, H. Sato, H. Tateishi, T. Kawagoe, Y. Shimatani, S. Kurisu, K. Sakai, K. Ucda, Implications of prodromal angina pectoris in anterior Wall acute myocardial infarction acute angiographic findings and long-term prognosis, J Am Coll Cardiol 31, 1701 (1998). 

Figure 4.16 Acute myocardial infarction in a patient with rapid atrial fibrillation. The ECG shows ST-segment elevation in V2-V5, I and VL. Leads II, III, and VF present an evident ST-segment depression as a mirror pattern of ST-segment elevation in precordial leads. This is a pattern of acute coronary syndrome with ST-segment elevation of the anterior wall according to the classical classification.

Figure 5.47 Patient with complete RBBB and myocardial infarction type A-3 (extensive anterior Ml). Observe the Q wave in precordial leads and the QS morphology in VL. In CE-CMR images (A-E) show important involvement of lateral, anterior and septal walls, and even the lower part...

Figure 5.52 The ECG of a patient with complete LBBB and associated infarction. There are ECG criteria suggestive of extensive anterior myocardial infarction (qR in I, QR in VL and low voltage of S in V3). The CMR images (A-D) demonstrated the presence of an extensive infarction of anteroseptal zone (type A-3) (proximal LAD occlusion). The inferolateral wall is free of necrosis (see (D)), because the...

Figure 9.2 Apical-anterior Ml. (A) ECG showing Q waves in V1-V3 with rS V4-V5 corresponding to an apical-anterior myocardial infarction. (B) CE-CMR image in a sagittal view myocardial hyperenhancement (arrows) shows a non-transmural necrosis of the anterior wall. (C-E) Transversal images show myocardial hyperenhancement (arrows) at low basal, mid and apical levels of the anterior...

Arbane M, Goy JJ. Prediction of the site of total occlusion in the left anterior descending coronary artery using admission electrocardiogram in anterior wall acute myocardial infarction. Am J Cardiol 2000 85 487. 

Ben-Gal T, Herz I, Solodky A, Birnbaum Y, Sclarovsky S, Sagie A. Acute anterior wall myocardial infarction entailing ST elevation in VI electrocardiographic and angiographic correlations. Clin Cardiol 1998 21 399. 

Birnbaum Y, Sclarovsky S, Blum A, Mager A, Gabbay U. Prognostic significance of the initial electrocardiographic pattern in a first acute anterior wall myocardial infarction. Chest 1993 103 1681. 

Sagie A, Sclarovsky S, Strasberg B et al. Acute anterior wall myocardial infarction presenting with positive T waves and without ST segment shift. Electrocardiographic features and angiographic correlation. Chest 1989 95(6) 1211-15. 

Sapin PM, Musselman DR, Dehmer GJ, Cascio WE. Implications of inferior ST segment elevation accompanying anterior wall myocardial infarction for the angiographic morphology of the left anterior descending coronary artery morphology and site of occlusion. Am J Cardiol 1992 69 860. 

Romeo F, Rosano GMC, Martuscelli E, De Luca F, Bianco C, Colistra C, Comito M, Cardona N, Miceli F, Rosano V, I hta JL, Concurrent nitroglycerin administration reduces the efficacy of recombinant tissue-type plasminogen activator in patients with acute anterior wall myocardial infarction. Am Heakj (1995) 130, 692-7,... 

Prophylactic Temporary Pacemaker Insertion. Approximately 1% of patients with acute myocardial infarction develop a Type n second-degree AV block. Although this rhythm is often tolerated hemodynamically, because there can be sudden progression to complete AV block, temporary pacing should be considered. New bundle-branch block (BBB) has been associated with an 18% risk of transient complete AV block (9-11). The development of BBB usually signifies an extensive infarction, typically involving the anterior wall. Death in these patients usually results from left ventricular pump failure, although 9% of deaths have been attributable to complete AV block (9). 

Fig. 20.5a-d. Contrast-enhanced DSCT of the heart performed in a 58-year-old male patient who had suffered a large myocardial infarction of the anterior and septal wall of the left ventricle (i.e., the vascular supply territory of the LAD). A se-... 

Fig. 20.9a-d. Typical morphologic aspects and potential sequelae of chronic myocardial infarctions. In a 47-year-old male patient scanned with 16-SCT, a sharply demarcated area with noticeable lower attenuation compared with the surrounding myocardium as well as a significant wall thinning is seen in the anterior left ventricular wall on the original axial CT source... 

Fig. 21.11a-c. Comprehensive MR assessment of the cardiac status in a patient after myocardial infarction, a Cine imaging demonstrates normal end-diastolic thickness of the LV wall, while (b) myocardial perfusion (at rest) shows an extensive hypoperfusion within the anterior and anteroseptal LV wall... 

A 62-year-old male smoker presented to emergency department with anaphylaxis, due to oral diclcfenac for toothache. He developed acute anterior wall myocardial infarction following adrenaline (i.m.) Img 1 1000. Primary percutaneous coronary intervention was done, which showed a thrombus in the mid left anterior descending artery with no evidetwe of obstructive coronary artery disease after thrombus aspiration [14 ]. 

Kumar B, Agrawal N, Patra S, Marq unath CN. Occurrence of GuiUain-Barre syndrome as an inunune mediated complication after thrombolysis with streptokinase for acute anterior wall myocardial infarction a caution to be vigilant. BMJ Case Rep October 7,2013 2013. http // dx.doi.org/10.1136/bcr-2013-200602. pii bcr2013200602. 

This 12-lead electrocardiogram shows typical characteristics (Vj, Vj, V4) of an anterior-wall myocardial infarction (Ml). Note that the R waves don t progress through the precordial leads. Also note the ST-segment elevation in leads Vj and Vj. As expected, the reciprocal leads II, III, and aVp show slight ST-segment depression. 

Right bundle-branch block occurs with such conditions as anterior-wall myocardial infarction, coronary artery disease, and pulmonary embolism. However, it also may occur without cardiac disease. If it develops as the patient s heart rate increases, it s known as rate-related right bundle-branch block. 

Normal physiologic response to fever, exercise, anxiety, pain, dehydration may also accompany shock, left-sided heart failure, cardiac tamponade, hyperthyroidism, anemia, hypovolemia, pulmonary embolism, and anterior-wall myocardial infarction (Ml). 

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