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Indian Journal of Emergency Medicine 3(2):p 286-289, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.24
Case Report
Acute Isolated Posterior Myocardial Infarction; Challenges in Recognition and Management in the Emergency Department
Sarat Kumar Naidu, DNB Resident, Department of Emergency Medicine, Max Hospital, Shalimar Bagh, New Delhi, Delhi 110088, India. , Sarat Kumar Naidu1 , Ankur Pandey1 , Kishalay Datta2
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Indian Journal of Emergency Medicine 3(2):p 286-289, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.24
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Abstract
Posterior wall myocardial infarction (PWMI) accounts for about 1520% of all STEMIs and is usually seen in the context of inferior and/or lateral wall MI [2]. Isolated posterior wall MI are much less common, of about only 3.3% of all myocardial infarcts [1]. The clinical presentation of PWMI may not be very specific and is confusing even for a cardiologist. Moreover the lack of ST elevation in a standard 12lead ECG leads to missed or delayed diagnosis of a true PWMI. We are reporting a case of isolated PWMI in a 65 years old, previously healthy male patient, who presented with only gradual onset shortness of breath, who was later found to have 100% LCx stenosis. We have tried to emphasize some facts that may make the clinicians aware of a possible PWMI.
Keywords: ST Elevation Myocardial Infarction (STEMI); LCx; PWMI; Posterior ECG Leads V7 V8 V9; Right Coronary Artery (RCA); Left Anterior Descending Artery (LAD); ST Depression; Dominant R Wave; Flip Test; Coronary Angiography (CAG); Troponin I; Percutaneous; Coronary Intervention (PCI); Stenting.
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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.24
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