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May 1983

True Posterior Myocardial Infarction

Author Affiliations

From the Section of Cardiology, Department of Medicine, University of Illinois College of Medicine, Chicago. Dr Swiryn is now with Evanston (Ill) Hospital.

Arch Intern Med. 1983;143(5):983-985. doi:10.1001/archinte.1983.00350050143025

Although the standard 12-lead ECG is useful in establishing the diagnosis of myocardial infarction, its value is limited in determining the exact anatomic location and the extent of the infarction.1,2

The ECG terminology of infarct location with use of a host of terms like "anterior," "septal," "high lateral," "lateral," "inferior," "posterior," "diaphragmatic," "apical," "basal," "true posterior," "anterobasal," "anteroseptal," "inferolateral," and so forth implies a capability for spatial resolution. However, there is evidence that the ECG provides inadequate information for such a detailed and exact classification.1'3 Thus, these terms often describe ECG distinctions rather than precise anatomic distinctions.

The term "posterior infarction" in the older ECG literature was used to denote what is now called "inferior or diaphragmatic myocardial infarction." The term true posterior infarction (also known as "high posterior," "strictly posterior," "pure posterior," "posterobasal, inferobasal, or dorsal paravertebral") refers to involvement of the posterior aspect or infra-atrial part