eMedicine Specialties > Emergency Medicine > Cardiovascular

Myocardial Infarction: Multimedia

Author: Drew Evan Fenton, MD, Hospitalist, Our Health Care Consultants
Contributor Information and Disclosures

Updated: Oct 5, 2009

Multimedia

A 53-year-old patient who had experienced 3 hours...
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Media file 1: A 53-year-old patient who had experienced 3 hours of chest pain had a 12-lead ECG performed, and the results are as shown. He was given sublingual nitroglycerin and developed severe symptomatic hypotension. His blood pressure normalized with volume resuscitation.
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A 53-year-old patient who had experienced 3 hours...

A 53-year-old patient who had experienced 3 hours of chest pain had a 12-lead ECG performed, and the results are as shown. He was given sublingual nitroglycerin and developed severe symptomatic hypotension. His blood pressure normalized with volume resuscitation.

The right-sided leads indicate ST-segment elevati...
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Media file 2: The right-sided leads indicate ST-segment elevations in RV4 and RV5, which are consistent with an right ventricular infarct.
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The right-sided leads indicate ST-segment elevati...

The right-sided leads indicate ST-segment elevations in RV4 and RV5, which are consistent with an right ventricular infarct.

The ECG shows lateral ST-segment elevation that i...
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Media file 3: The ECG shows lateral ST-segment elevation that is consistent with a lateral wall AMI.
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The ECG shows lateral ST-segment elevation that i...

The ECG shows lateral ST-segment elevation that is consistent with a lateral wall AMI.

This patient has a symptom duration of fewer than...
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Media file 4: This patient has a symptom duration of fewer than 12 hours. In the setting of active chest pain and ECG changes showing AMI, he would still benefit from thrombolysis. His history of surgery is not a contraindication and his blood pressure can be controlled with nitrates and beta-blockers.
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This patient has a symptom duration of fewer than...

This patient has a symptom duration of fewer than 12 hours. In the setting of active chest pain and ECG changes showing AMI, he would still benefit from thrombolysis. His history of surgery is not a contraindication and his blood pressure can be controlled with nitrates and beta-blockers.

This patient has an inferior wall MI indicated on...
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Media file 5: This patient has an inferior wall MI indicated on the ECG. Approximately 20% of inferior MIs are right ventricular. Nitroglycerin will drop the preload; right ventricular (RV) output is very preload-dependent. Right-sided chest leads would be useful in demonstrating ST-segment elevations in RV4 and RV5.
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This patient has an inferior wall MI indicated on...

This patient has an inferior wall MI indicated on the ECG. Approximately 20% of inferior MIs are right ventricular. Nitroglycerin will drop the preload; right ventricular (RV) output is very preload-dependent. Right-sided chest leads would be useful in demonstrating ST-segment elevations in RV4 and RV5.

More on Myocardial Infarction

Overview: Myocardial Infarction
Differential Diagnoses & Workup: Myocardial Infarction
Treatment & Medication: Myocardial Infarction
Follow-up: Myocardial Infarction
Multimedia: Myocardial Infarction
References
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References

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Further Reading

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Keywords

signs of myocardial infarction, symptoms of myocardial infarction, non stemi myocardial infarction, MI, acute myocardial infarction, AMI, heart attack, chest pain, hypertension, mitral regurgitation, dysrhythmias, acute valvular dysfunction, congestive heart failure, CHF, third heart sound, fourth heart sound, heart block, emboli, right ventricular failure, cannon jugular venous a waves, left ventricular hypertrophy, coronary artery vasospasm, acute coronary syndrome

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Contributor Information and Disclosures

Author

Drew Evan Fenton, MD, Hospitalist, Our Health Care Consultants
Drew Evan Fenton, MD is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Robert M McNamara, MD, FAAEM, Chair and Professor, Department of Emergency Medicine, Temple University School of Medicine
Robert M McNamara, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Association, Pennsylvania Medical Society, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Gary Setnik, MD, Chair, Department of Emergency Medicine, Mount Auburn Hospital; Assistant Professor, Division of Emergency Medicine, Harvard Medical School
Gary Setnik, MD is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, and Society for Academic Emergency Medicine
Disclosure: SironaHealth Salary Management position; South Middlesex EMS Consortium Salary Management position

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

David FM Brown, MD, Assistant Professor, Division of Emergency Medicine, Harvard Medical School; Vice Chair, Department of Emergency Medicine, Massachusetts General Hospital
David FM Brown, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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