ECG Guru - Instructor Resources - Circumflex occlusion https://www.ecgguru.com/ecg/circumflex-occlusion en Circumflex Occlusion with Posterior-lateral M.I. https://www.ecgguru.com/ecg/circumflex-occlusion-posterior-lateral-mi <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/circumflex-occlusion-posterior-lateral-mi"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/OMI%20100_0.jpg" width="1800" height="1320" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p><span style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; line-height: normal;">This ECG was obtained from a woman with chest pain who was taken to the cath lab and found to have a 100% occlusion of her circumflex artery. &nbsp;</span></p><p><span style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; line-height: normal;">There are obvious ST segment elevations in Leads I and aVL, as well as in Lead II. &nbsp;Lead II is the most leftward of the inferior wall leads, and I and aVL reflect the high lateral wall. She also has ST depressions in V1 through V3. &nbsp;If you look closely at the R wave progression in the anterior leads, you will readily note that it appears that V1 and V3 wires have been reversed. &nbsp;That being said, the "real" V2 and V3 have taller-than-normal R waves. &nbsp;The tall R waves and ST depression are signs of "posterior wall M.I." &nbsp;Recently, the actual definitions of the "lateral" wall and "posterior" wall have come into <a title="Circulation LV walls defined" href="http://circ.ahajournals.org/content/114/16/1755.full">question.</a> &nbsp;However, the important thing clinically, is that this patient IS experiencing an ST elevation M.I. (STEMI), which was confirmed in the cath lab. &nbsp;The locations of the ST changes were consistent with the 100% occlusion of her circumflex artery.</span></p><p><span style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; line-height: normal;">For our more advanced readers (and our "Gurus"), there is an interesting rhythm. &nbsp;The P wave morphology changes frequently, even though the rhythm remains regular. &nbsp;The rate, at 62 BPM, was adequate, and the patient did not suffer any consequential dysrhythmias during her procedure. &nbsp;We don't have long-term followup information on her.</span></p><p><span style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; line-height: normal;"><br /></span></p><p><span style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; line-height: normal;"><br /></span></p><p>&nbsp;</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/562/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Circumflex Occlusion with Posterior-lateral M.I. 1/5</option><option value="40">Give Circumflex Occlusion with Posterior-lateral M.I. 2/5</option><option value="60">Give Circumflex Occlusion with Posterior-lateral M.I. 3/5</option><option value="80">Give Circumflex Occlusion with Posterior-lateral M.I. 4/5</option><option value="100" selected="selected">Give Circumflex Occlusion with Posterior-lateral M.I. 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4.3</span></span> <span class="total-votes">(<span >3</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-gUe5TpojssxAt09pABrPDmrP5ZU8CHmySlTLqQ5LV-o" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/posterior-wall-mi" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Posterior wall M.I.</a></div><div class="field-item odd"><a href="/ecg/lateral-wall-mi" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Lateral wall M.I.</a></div><div class="field-item even"><a href="/ecg/circumflex-occlusion" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Circumflex occlusion</a></div><div class="field-item odd"><a href="/ecg/stemi" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">STEMI</a></div><div class="field-item even"><a href="/ecg/myocardial-infarction" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Myocardial infarction</a></div><div class="field-item odd"><a href="/ecg/st-depression" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ST depression</a></div><div class="field-item even"><a href="/ecg/st-elevation" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ST elevation</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fcircumflex-occlusion-posterior-lateral-mi&amp;title=Circumflex%20Occlusion%20with%20Posterior-lateral%20%20M.I."><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Thu, 12 Mar 2015 19:00:10 +0000 Dawn 627 at https://www.ecgguru.com https://www.ecgguru.com/ecg/circumflex-occlusion-posterior-lateral-mi#comments