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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]
I, aVL, V5, V6 correspond to the lateral wall; V3-V4 correspond to the anterior wall ; V1-V2 correspond to the septal wall; II, III, aVF correspond to the inferior wall.) This criterion is problematic, however, as acute myocardial infarction is not the most common cause of ST segment elevation in chest pain patients. [6]
12-lead electrocardiogram showing ST-segment elevation (orange) in I, aVL and V1-V5 with reciprocal changes (blue) in the inferior leads, indicative of an anterior wall myocardial infarction. The primary purpose of the electrocardiogram is to detect ischemia or acute coronary injury in broad, symptomatic emergency department populations.
The lateral wall of the left ventricle is supplied by branches of the left anterior descending (LAD) and left circumflex (LCx) arteries. [8] Infarction of the lateral wall will thus lead to deviation of the axis away from the site of infarction.
CK-MB starts to rise 2-4 hours after infarction, peaks around 24 hours, and returns to normal after 48 hours. Since CK-MB returns to normal more quickly, it can be useful to diagnose reinfarction, a second infarction that happens after 48 hours but before troponin levels go back to normal. A second heart attack happens following 10% of MIs.
12-lead electrocardiogram showing ST-segment elevation (orange) in I, aVL and V1–V5 with reciprocal changes (blue) in the inferior leads, indicative of an anterior wall myocardial infarction. When there is a blockage of the coronary artery, there will be lack of oxygen supply to all three layers of cardiac muscle (transmural ischemia).
A myocardial infarction, also known as a heart attack, often result in the formation of fibrosis. [2] A myocardial infarction is an ischemic event, or a restriction of blood flow to body tissue, such as by atherothrombosis. [4] Without blood flow to the myocardium, it is deprived of oxygen, causing tissue death and irreversible damage. [5]
It can be seen in approximately 4% of cases of acute myocardial infarction [citation needed] It is the most common type of intraventricular conduction defect seen in acute anterior myocardial infarction, and the left anterior descending artery is usually the culprit vessel. It can be seen with acute inferior wall myocardial infarction.
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