The electrocardiographic manifestations of multiple infarction of the myocardium are always interesting, frequently puzzling, and sometimes missed entirely. In particular, the studies of evolutions of patterns of combined anterior and posterior infarction are still inadequate and incomplete. Yet the coexistence of such a combined lesion is a fairly common pathologic entity and has been reported to be as high as 32.3%.1
There are many reports of the "neutralization" of abnormalities in the electrocardiogram when a new infarct succeeds an old one in the opposite wall.* It has been pointed out that in such cases the tracings demonstrate a decided improvement that may not be warranted by the clinical findings. These electrocardiographic neutralization effects are by no means uniform or complete, and very often it is possible to detect the residuals of an old infarct in tracings depicting a recent one. Furthermore, one sees patterns of combined or multiple infarctions
CHIEFFO HD, CASCIANO AD. Combined Anterior and Posterior Myocardial Infarction: An Electrocardiographic Study. AMA Arch Intern Med. 1955;95(6):834–839. doi:10.1001/archinte.1955.00250120070009
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