Myocardial infarction lateral-wall

One case of an acute lateral wall myocardial infarction (MI) was reported in a woman after daily ingestion of Edita s Skinny Pill (containing 300 mg bitter orange plus caffeine and guarana) for 1 year (44). The 55-year-old Caucasian woman developed chest discomfort after eating Chinese food. After workup at the hospital, the woman was diagnosed with acute lateral-wall MI and smoking addiction. Her ejection fraction was 0.45. Prior to this incident, she had no known coronary artery disease, hypertension, or hyperlipidemia. 

Nykamp DL, Fackih MN, Compton AL. Possible association of acute lateral-wall myocardial infarction and bitter orange supplement. Ann Pharmacother 2004 38 812-816. 

Figure 3.17 (A) and (B) ECG-VCG correlation of the T wave and the T loop of subepicardial ischaemia in two patients with myocardial infarction (A) of the inferior wall and (B) of the inferior and lateral walls. Observe that a T loop in both cases shows homogeneous inscription and is directed upwards (see FPa) in the first case and upwards and forward in the second case (see HPa). The QRS loop of (A) rotates only clockwise and of (B) rotates first clockwise and later counter-clockwise. In the first case inferior Ml is isolated and in the second, associated to superoanterior...

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...

Generally, they are not large infarctions, especially when the ECG is normal or near normal (Figure 10.2). However, in presence of normal ECG recording in some cases, the myocardial mass involved may be relatively important, because a great part of the lateral wall depolarises after 40 milliseconds and, therefore, does not generate... 

Data also exist to suggest that patients with transmural myocardial infarctions of the lateral wall are unlikely to improve with lateral left ventricular pacing (56). Echocardiographic substudies of MIRACLE (23) and MUSTIC (22) have shown greater reverse remodeling in patients with nonischemic as opposed to ischemic cardiomyopathies. It is, however, important to recognize that substudy analysis shows no difference in clinical outcomes between patients with ischemic versus nonischemic heart disease (10,21,30). 

An acute lateral-wall myocardial infarction was reported in a 55-year-old woman with a 1-year history of use of a weight loss product containing 300 mg Citrus aurantium (no other description provided) as well as 30 mg caffeine (misidentified as guararanine [sic]) and 30 mg green tea (no other description). The patient also reported a nearly 40-year tobacco-smoking habit (IVl packs per day), high caffeine intake from cola, coffee, and tea, and a preexisting heart murmur (Nykamp et al. 2004). 

Pregnancy other mechanical shifts Aging process Inferior/lateral wall MI (Myocardial Infarction) Hemiblocks... 

This 12-lead electrocardiogram shows typical characteristics of a lateral-wall myocardial infarction (Ml). Note the ST-segment elevation in leads I, aV, Vj, and Vg. 

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