Lateral myocardial infarction

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Acute Coronary Syndrome Main Page

ST Elevation Myocardial Infarction Microchapters


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Pathophysiology of Vessel Occlusion
Pathophysiology of Reperfusion
Gross Pathology


Differentiating ST elevation myocardial infarction from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History and Complications

Risk Stratification and Prognosis



Diagnostic Criteria

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EKG Examples

Chest X Ray

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Pre-Hospital Care

Initial Care

Beta Blockers
The coronary care unit
The step down unit
STEMI and Out-of-Hospital Cardiac Arrest
Pharmacologic Reperfusion
Reperfusion Therapy (Overview of Fibrinolysis and Primary PCI)
Reperfusion at a Non–PCI-Capable Hospital:Recommendations
Mechanical Reperfusion
The importance of reducing Door-to-Balloon times
Primary PCI
Adjunctive and Rescue PCI
Rescue PCI
Facilitated PCI
Adjunctive PCI
Management of Patients Who Were Not Reperfused
Assessing Success of Reperfusion
Antithrombin Therapy
Antithrombin therapy
Unfractionated heparin
Low Molecular Weight Heparinoid Therapy
Direct Thrombin Inhibitor Therapy
Factor Xa Inhibition
DVT prophylaxis
Long term anticoagulation
Antiplatelet Agents
Thienopyridine Therapy
Glycoprotein IIbIIIa Inhibition
Other Initial Therapy
Inhibition of the Renin-Angiotensin-Aldosterone System
Magnesium Therapy
Glucose Control
Calcium Channel Blocker Therapy
Lipid Management

Pre-Discharge Care

Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT

Post Hospitalization Plan of Care

Long-Term Medical Therapy and Secondary Prevention

Inhibition of the Renin-Angiotensin-Aldosterone System
Cardiac Rehabilitation
Pacemaker Implantation
Long Term Anticoagulation
Implantable Cardioverter Defibrillator
ICD implantation within 40 days of myocardial infarction
ICD within 90 days of revascularization

Case Studies

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Lateral myocardial infarction On the Web

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Directions to Hospitals Treating ST elevation myocardial infarction

Risk calculators and risk factors for Lateral myocardial infarction

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Lateral MI


A lateral myocardial infarction (MI) is a heart attack or cessation of blood flow to the heart muscle that involves the inferior side of the heart. Inferior MI results from the total occlusion of the left circumflex artery. Lateral MI is characterized by ST elevation on the electrocardiogram (EKG) in leads I and aVL.

EKG Examples

Shown below is an EKG demonstrating sinus rhythm and a QRS with a rightward axis, as well as wide Q waves in leads I and aVL as well as a poor R wave progression across the anterior chest leads. There is also slight ST elevation in leads I,aVL, and T wave inversion in the lateral leads. The EKG is consistent with a lateral wall myocardial infarction.

STEMI 35.jpg

Copyleft image obtained courtesy of,

Shown below is an EKG demonstrating sinus rhythm. The remarkable feature is the poor R wave progression in the V1 and V2 leads and the ST elevation and T wave changes in leads V1 to V4 and I and aVL. The cardiogram suggests an anterior/ lateral MI possibly acute. There is also terminal P wave negativity in V1 suggesting a left atrial abnormality.

Acute ant-lateral MI.jpg

Copyleft image obtained courtesy of,

Shown below is an EKG demonstrating acute myocardial infarction in in a patient with a pacemaker and LBBB. Concordant ST elevation in V5-V6 are clearly visible. There is discordant ST segment elevation > 5 mm in lead V3.

STEMI 25.jpg

Copyleft image obtained courtesy of,

Shown below is an EKG demonstrating findings in the same patient as in the first example 2 months before the myocardial infarction. Normal LBBB pattern.

STEMI 25 a.jpg

Copyleft image obtained courtesy of,

Shown below is an EKG showing ST elevation MI.

STEMI 29.jpg

Copyleft image obtained courtesy of,


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