Why the study?
Does the use of high lateral and posterior ECG leads improve the diagnosis of acute myocardial infarction in patients with subtle conventional ECG abnormalities?
Does the use of high lateral and posterior ECG leads improve the diagnosis of acute myocardial infarction in patients with subtle conventional ECG abnormalities?
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The use of a 15-lead ECG including high lateral and posterior leads can enhance diagnostic yield for posterior myocardial infarction in patients with suspicious symptoms and subtle conventional ECG findings.
We report the case of a 50-year-old man with history of hypertension who presented with chest pain and subtle electrocardiographic (ECG) abnormalities. Only with the aid of additional high lateral and posterior ECG leads (V7-9) was a posterolateral acute myocardial infarction identified and subsequently confirmed with positive cardiac enzyme serology. Coronary angiography showed total occlusion of the left circumflex coronary artery, which was successfully recanalized via coronary angioplasty and stenting. This case highlights the use of high lateral and posterior ECG leads (15-lead ECG) in enhancing the diagnostic yield of a conventional ECG in patients presenting with symptoms suspicious for an acute coronary syndrome by disclosing a posterior myocardial infarction and guiding reperfusion therapy.
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Metaxa et al. (2011) studied this question.
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