Circulation, Vol 55, 279-285, Copyright © 1977 by American Heart Association
RM Savage, GS Wagner, RE Ideker, SA Podolsky and DB Hackel
This retrospective study correlates electrocardiographic and
histopathologic findings in 24 patients with single well-circumscribed
infarcts to determine 1) whether ECG terms commonly used to describe the
location of myocardial infarcts are significant, and 2) whether the extent
of infarct can be determined using QRS characteristics. Transverse sections
of the hearts were photographed. Based on histologic sections, the infarct
was outlined on the photograph and each section was planimetered via a
sonic digitizer into a computer that was programmed to divide the left
ventricle into 8 radial sectors and also into basal, mesial, and apical
thirds. The percentage of infarct in each of these areas was then
calculated. Of the 24 hearts evaluated 12 had posterior infarcts and 12 had
anterior infarcts. Posterior infarcts principally involved the basal and
mesial levels, whereas the anterior infarcts were more extensive in the
apical and mesial thirds, with relative or total sparing of the base.
Posterior infarcts were associated with Q waves in leads II, III and aVF in
11 instances. The other posterior infarct was associated with markedly
diminished R waves in leads II, III and aVf in the presence of a horizontal
axis. All anterior infarcts were associated with Q waves or markedly
diminished R waves in the right precordial leads. Eight of the anterior
infarcts exhibited circumferential apical involvement and all eight were
associated with Q waves or markedly diminished R waves in the left
precordial leads. This study documents the electrocardiographic
identification of anterior, posterior, and apical infarcts by correlation
with pathologic anatomy.
ARTICLES
Correlation of postmortem anatomic findings with electrocardiographic changes in patients with myocardial infarction: retrospective study of patients with typical anterior and posterior infarcts
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