Myocardial infarction inferolateral

When adenosine (70 micrograms/kg/minute) was given by intravenous infusion to 45 patients with acute myocardial infarction preceding balloon angioplasty, one patient developed persisting hypotension in conjunction with a large inferolateral myocardial infarction (18). Transient hypotension in three other patients resolved with a reduction in dosage. There were no cases of atrioventricular block. 

A previously healthy 19-year-old man took tablets containing a total of 24 mg of Ephedra alkaloids and 100 mg of caffeine, and 15 minutes later developed severe chest pain radiating down the left arm. An electrocardiogram showed an inferolateral myocardial infarct, confirmed by creatine kinase and troponin I measurements. He made a full recovery, and coronary angiography showed only minimal atherosclerotic disease of the left anterior descending artery. 

Figure 4.17 Acute myocardial infarction with ST-segment elevation in II, III and VF and ST-segment depression in V1-V3. This pattern corresponds classically to an infarction involving inferior and posterior walls. Nowadays, this is the pattern of STE-ACS of inferolateral zone evolving to inferolateral infarction due to distal occlusion of a dominant RCA (ST-segment depression in I and V1-V3,...

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 8.13 (1) The three types of repolarisation abnormalities that may be seen in an acute phase of myocardial infarction involving the inferolateral zone ...

Anteroseptal versus inferolateral MI prognostic implications. It is known that the MI involving LAD presents for similar area of necrosis, increased myonecrosis, reduced early and late left-ventricular function and high mortality compared with infarction in other vascular territories. However, the mechanisms underlying a worse prognosis are not completely characterised. Recently, it has been demonstrated (Kandzari et al, 2006) that prognosis after primary PCI in patient with ACS, the majority with ST-segment elevation, is different in patients with LAD occlusion than in RCA or LCX. Acute myocardial infarction due to LAD is associ-... 

Bayes de Luna A, Cino J, Kotzeva A et al. New ECG criteria of inferolateral myocardial infarction assessed by contrast enhanced-cardiovascular magnetic resonance based on the morphology of QRS in VI. Eur Heart J Supl 2006b 27 871. Abstract. 

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