Document Detail


Inferior-septal myocardial infarction misdiagnosed as anterior-septal myocardial infarction: electrocardiographic, scintigraphic, and angiographic correlations.
MedLine Citation:
PMID:  18246669     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To explore the infarct sites in patients with inferior wall acute myocardial infarction (AMI) concomitant with ST segment elevation in leads V1-V3 and leads V3R-V5R. METHODS: Five patients diagnosed as inferior, right ventricular, and anteroseptal walls AMI at admission were enrolled. Electrocardiographic data and results of isotope 99mTc-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging and coronary angiography (CAG) were analyzed. RESULTS: Electrocardiogram showed that ST segment significantly elevated in standard leads II, III, aVF, and leads V1-V3, V3R-V5R in all five patients. The magnitude of ST segment elevation was maximal in lead V1 and decreased gradually from lead V1 to V3 and from lead V1 to V3R-V5R. There was isotope 99mTc-MIBI myocardial perfusion imaging defect in inferior and basal inferior-septal walls. CAG showed that right coronary artery was infarct-related artery. CONCLUSIONS: The diagnostic criteria for basal inferior-septal wall AMI can be formulated as follows: (1) ST segment elevates > or = 2 mm in lead V1 in the clinical setting of inferior wall AMI; (2) the magnitude of ST segment elevation is the tallest in lead V1 and decreases gradually from lead V1 to V3 and from lead V1 to V3R-V5R. With two conditions above, the basal inferior-septal wall AMI should be diagnosed.
Authors:
Ji-lin Chen; Zuo-xiang He; Zai-jia Chen; Jin-qing Yuan; Yue-qin Tian; Shu-bin Qiao; Rong-fang Shi; Yi-da Tang; Zong-lang Lu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chinese medical sciences journal = Chung-kuo i hsüeh k'o hsüeh tsa chih / Chinese Academy of Medical Sciences     Volume:  22     ISSN:  1001-9294     ISO Abbreviation:  Chin. Med. Sci. J.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2008-02-05     Completed Date:  2009-04-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9112559     Medline TA:  Chin Med Sci J     Country:  China    
Other Details:
Languages:  eng     Pagination:  228-31     Citation Subset:  IM    
Affiliation:
Center for Diagnosis & Treatment of Coronary Heart Disease, Cardiovascular Institute & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing. jilin.chen@263.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Diagnostic Errors
Female
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis*,  physiopathology,  radionuclide imaging
Radionuclide Imaging

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