Electrocardiographic changes correlated with postmortem anatomic findings, identifying 11 of 12 posterior infarcts via Q waves in leads II, III, and aVF.
Observational (n=24)
Does electrocardiography accurately identify the anatomic location and extent of myocardial infarction in patients with single well-circumscribed infarcts?
This study validates the use of specific electrocardiographic changes to accurately identify the anatomic location of anterior, posterior, and apical myocardial infarcts.
This retrospective study correlates electrocardiographic and histopathologic findings in 24 patients with single well-circumscribed infarcts to determine 1) whether ECG terms commonly used to describe the location of myocardial infarcts are significant, and 2) whether the extent of infarct can be determined using QRS characteristics. Transverse sections of the hearts were photographed. Based on histologic sections, the infarct was outlined on the photograph and each section was planimetered via a sonic digitizer into a computer that was programmed to divide the left ventricle into 8 radial sectors and also into basal, mesial, and apical thirds. The percentage of infarct in each of these areas was then calculated. Of the 24 hearts evaluated 12 had posterior infarcts and 12 had anterior infarcts. Posterior infarcts principally involved the basal and mesial levels, whereas the anterior infarcts were more extensive in the apical and mesial thirds, with relative or total sparing of the base. Posterior infarcts were associated with Q waves in leads II, III and aVF in 11 instances. The other posterior infarct was associated with markedly diminished R waves in leads II, III and aVf in the presence of a horizontal axis. All anterior infarcts were associated with Q waves or markedly diminished R waves in the right precordial leads. Eight of the anterior infarcts exhibited circumferential apical involvement and all eight were associated with Q waves or markedly diminished R waves in the left precordial leads. This study documents the electrocardiographic identification of anterior, posterior, and apical infarcts by correlation with pathologic anatomy.
Savage et al. (1977) conducted an observational in Myocardial infarction (n=24). Electrocardiography vs. Postmortem anatomic findings was evaluated on Correlation of electrocardiographic and histopathologic findings. Electrocardiographic changes correlated with postmortem anatomic findings, identifying 11 of 12 posterior infarcts via Q waves in leads II, III, and aVF.