Lead definition

  Classically

      Lateral leads :
V5 and V6.

      High lateral leads :
I and aVL.

  ST segment elevation and/or negative T waves in these leads may suggest myocardial infarction.

  Unlike acute anterior myocardial infarction, lateral myocardial infarction does not usually result in

      prominent ST segment elevation.

  If the diagnosis is not clear, repeat the ECG recording at a calibration of 20 mm/mV.

  In daily clinical practice, many patients show extension of the ischemic changes

      into the neighbouring regions. Additionally, the treatment strategies do not differ for both.

      Therefore, differentiation between lateral and high lateral myocardial infarctions may not be so necessary

      in daily clinical practice.





ECG 1a. In a patient complaining of chest pain,
ST segment elevation in lateral leads show acute lateral infarction.

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ECG 1b. This ECG was recorded 15 minutes after the initiation of thrombolytic therapy. The
ST elevation in lateral leads are
more pronounced now.

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ECG 1c. This ECG was recorded immediately after the completion of thrombolytic therapy. The patient does not complain of
chest pain. Absence of the chest pain and the observation of accelerated idioventricular rhythm suggests that reperfusion of
the infarct-related artery has occurred.

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ECG 2. The above ECG is from a 67 years-old man who had experienced non-ST elevation myocardial infarction 24 hours ago.
His cardiac enzymes were elevated. Coronary angiography showed 99% stenosis of the well-developed intermediate artery.
The symmetrically negative T waves in leads V4 to V6 do not look like to asymmetrically negative T waves of LV strain pattern.

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ECG 3a. The above ECG is from a 72 years-old man with the complaint of chest pain.
What is your diagnosis?

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ECG 3b. Above is his immediately repeated ECG (at a calibration of 20 mm/mV).
ST segment elevation is seen clearly in leads V5 and V6. Leads I and aVL also show ST elevation: Acute lateral myocardial infarction.
Unlike acute anterior myocardial infarction, lateral myocardial infarction does not usually result in prominent ST segment elevation.
If the diagnosis is not clear, repeat the ECG recording at a calibration of 20 mm/mV.

Click here for a more detailed ECG