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The use of additional ECG leads like right-sided leads V3R and V4R and posterior leads V7, V8, and V9 may improve sensitivity for right ventricular and posterior myocardial infarction. In spite of these limitations, the 12 lead ECG stands at the center of risk stratification for the patient with suspected acute myocardial infarction.
In particular, acute myocardial infarction in the distribution of the circumflex artery is likely to produce a nondiagnostic ECG. [10] The use of additional ECG leads like right-sided leads V3R and V4R and posterior leads V7, V8, and V9 may improve sensitivity for right ventricular and posterior myocardial infarction. [citation needed]
A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction (tissue death) to the heart muscle. [1] The most common symptom is retrosternal chest pain or discomfort that classically radiates to the left shoulder, arm, or jaw. [1]
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG [a]), a recording of the heart's electrical activity through repeated cardiac cycles. [4] It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart [ 5 ] using electrodes placed on the skin.
The most common symptoms of MI include crushing chest pain or pressure that might radiate up to the left arm or jaw, sweating, nausea, and dyspnea. Treatment of MI includes re-establishing blood flow using medications, angioplasty, or percutaneous coronary intervention. Underlying risk factors should be addressed for long term management.
A left posterior fascicular block (LPFB), also known as left posterior hemiblock (LPH), is a condition where the left posterior fascicle, which travels to the inferior and posterior portion of the left ventricle, [1] does not conduct the electrical impulses from the atrioventricular node.
ECG would be abnormal in 75 to 95% of the patients. Characteristic ECG changes would be large QRS complex associated with giant T wave inversion [4] in lateral leads I, aVL, V5, and V6, together with ST segment depression in left ventricular thickening. For right ventricular thickening, T waves are inverted from V2 to V3 leads.
The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the left. The ECG will show a QS or rS complex in lead V1 and a monophasic R wave in lead I.
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