Evaluation of the electrocardiogram in identifying and quantifying lateral involvement in nonanterior wall infarction using cardiovascular magnetic resonance imaging

J Electrocardiol. 2012 Sep;45(5):478-84. doi: 10.1016/j.jelectrocard.2012.04.008. Epub 2012 May 18.

Abstract

Purpose: The objective of this study was to assess the involvement and extent of lateral wall myocardial infarction (MI) in patients with a first nonanterior wall MI, as reflected by changes in precordial leads. Delayed enhancement cardiac magnetic resonance imaging was used as a gold standard to localize and quantify myocardial scar tissue.

Methods: Electrocardiogram and cardiac magnetic resonance were studied in 56 patients. Areas involved were related to QRS changes in precordial leads.

Results: Significant correlations were found between lateral wall involvement and R waves in V(1) and V(6) (P = 0.009-0.022). For patients with circumflex branch occlusions, the MI size of the apical and lateral segments correlated strongly with the characteristics of R waves in V(1) and V(2) (P = 0.001-0.034).

Conclusions: Tall and broad R waves in V(1) reflect lateral wall MI, especially in circumflex occlusions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Contrast Media
  • Electrocardiography / methods*
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted
  • Linear Models
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Myocardial Infarction / physiopathology*

Substances

  • Contrast Media