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ECG Interpretation for Myocardial Infarction

This document provides an overview of diagnosing acute myocardial infarction (MI) using electrocardiograms (ECGs). It discusses that an MI is best diagnosed using a 12-lead ECG rather than just a rhythm strip. The 12-lead ECG views the heart from 12 angles and can identify ST segment elevation indicative of an MI. Certain leads are better for viewing different areas of the heart: leads V1-V4 view the anterior wall, leads I, aVL, and V5-V6 view the lateral wall, and leads II, III, and aVF view the inferior wall. The document provides examples of 12-lead ECGs demonstrating ST elevation patterns consistent with anterior, inferior, and anter

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Elsye Fitriasari
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61 views25 pages

ECG Interpretation for Myocardial Infarction

This document provides an overview of diagnosing acute myocardial infarction (MI) using electrocardiograms (ECGs). It discusses that an MI is best diagnosed using a 12-lead ECG rather than just a rhythm strip. The 12-lead ECG views the heart from 12 angles and can identify ST segment elevation indicative of an MI. Certain leads are better for viewing different areas of the heart: leads V1-V4 view the anterior wall, leads I, aVL, and V5-V6 view the lateral wall, and leads II, III, and aVF view the inferior wall. The document provides examples of 12-lead ECGs demonstrating ST elevation patterns consistent with anterior, inferior, and anter

Uploaded by

Elsye Fitriasari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

ECG Rhythm Interpretation

Module V
Acute Myocardial Infarction

Course Objectives
To recognize the normal rhythm of the
heart - Normal Sinus Rhythm.
To recognize the 13 most common
heart arrhythmias.
To recognize an acute myocardial
infarction on a 12-lead ECG.

Learning Modules

ECG Basics
How to Analyze a Rhythm
Normal Sinus Rhythm
Heart Arrhythmias
Diagnosing a Myocardial Infarction
Advanced 12-Lead Interpretation

Diagnosing a MI
To diagnose a myocardial infarction you
need to go beyond looking at a rhythm
strip and obtain a 12-Lead ECG.
12-Lead
ECG

Rhythm
Strip

The 12-Lead ECG


The 12-Lead ECG sees the heart
from 12 different views.
Therefore, the 12-Lead ECG helps
you see what is happening in different
portions of the heart.
The rhythm strip is only 1 of these 12
views.

The 12-Leads
The 12-leads include:
3 Limb leads
(I, II, III)
3 Augmented leads
(aVR, aVL, aVF)
6 Precordial leads
(V1- V6)

Views of the Heart


Some leads get a
good view of the:
Anterior portion
of the heart

Inferior portion
of the heart

Lateral portion
of the heart

ST Elevation
One way to
diagnose an
acute MI is to
look for
elevation of
the ST
segment.

ST Elevation (cont)
Elevation of the
ST segment
(greater than 1
small box) in 2
leads is
consistent with a
myocardial
infarction.

Anterior View of the Heart


The anterior portion of the heart is best
viewed using leads V1- V4.

Anterior Myocardial Infarction


If you see changes in leads V1 - V4
that are consistent with a myocardial
infarction, you can conclude that it is
an anterior wall myocardial infarction.

Putting it all Together


Do you think this person is having a
myocardial infarction. If so, where?

Interpretation
Yes, this person is having an acute anterior
wall myocardial infarction.

Other MI Locations
Now that you know where to look for an
anterior wall myocardial infarction lets
look at how you would determine if the MI
involves the lateral wall or the inferior wall
of the heart.

Other MI Locations
First, take a look
again at this
picture of the heart.

Anterior portion
of the heart

Inferior portion
of the heart

Lateral portion
of the heart

Other MI Locations
Second, remember that the 12-leads of the ECG look at different
portions of the heart. The limb and augmented leads see
electrical activity moving inferiorly (II, III and aVF), to the left (I,
aVL) and to the right (aVR). Whereas, the precordial leads see
electrical activity in the posterior to anterior direction.

Limb Leads

Augmented Leads

Precordial Leads

Other MI Locations
Now, using these 3 diagrams lets figure where
to look for a lateral wall and inferior wall MI.
Limb Leads

Augmented Leads

Precordial Leads

For more presentations [Link]

Anterior MI
Remember the anterior portion of the heart is
best viewed using leads V1- V4.
Limb Leads

Augmented Leads

Precordial Leads

Lateral MI
So what leads do you think
the lateral portion of the
heart is best viewed?

Limb Leads

Leads I, aVL, and V5- V6

Augmented Leads

Precordial Leads

Inferior MI
Now how about the inferior
portion of the heart?

Limb Leads

Leads II, III and aVF

Augmented Leads

Precordial Leads

Putting it all Together


Now, where do you think this person is
having a myocardial infarction?

Inferior Wall MI
This is an inferior MI. Note the ST elevation
in leads II, III and aVF.

Putting it all Together


How about now?

For more presentations [Link]

Anterolateral MI
This persons MI involves both the anterior wall
(V2-V4) and the lateral wall (V5-V6, I, and aVL)!

End of Module V
Acute Myocardial Infarction

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