tag:blogger.com,1999:blog-549949223388475481.post1459439873148242782..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: Inferior and Posterior STEMI. What else?Unknownnoreply@blogger.comBlogger9125tag:blogger.com,1999:blog-549949223388475481.post-26747064027044916452017-02-10T10:39:31.647-06:002017-02-10T10:39:31.647-06:00The circumflex supplies a large territory, some of...The circumflex supplies a large territory, some of it actually towards lateral lead V5, V6, aVL, I and some of it with the ST vector towards posterior lead V7-V8. There is a difference between lateral and posterior. And that is also why the echo segments are divided into basal inferior (posterior) and basal inferolateral (lateral)Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-34382055736315414582017-02-07T20:03:20.944-06:002017-02-07T20:03:20.944-06:00Hold on a sec... but the point is that those poste...Hold on a sec... but the point is that those posterior leads actually represent lateral infarcts - because that's the territory of the Cx artery. What you call "inferobasal" or "posterior" segment is irrelevant. Anonymoushttps://www.blogger.com/profile/11457710253513487490noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-44382296854258672122016-12-06T12:28:02.083-06:002016-12-06T12:28:02.083-06:00There clearly is a posterior wall, no matter what ...There clearly is a posterior wall, no matter what Bayes de Luna wants to call it. I have never agreed with this terminology and in the ECG world we still call it posterior, because it is indeed posterior. "inferobasal" is exactly posterior. The ST depression of the posterior (inferobasal) wall is exactly opposite to the anterior wall. You can measure the ST elevation by putting the leads on the posterior chest. This is a terminology change which appears to give Bayes de Luna several publications but does not make any practical sense. At least to me.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-87420731269273716862016-12-06T11:55:35.088-06:002016-12-06T11:55:35.088-06:00Hello there,
This came up in the google search so...Hello there, <br />This came up in the google search so I wanted to comment, given that this is a great ECG Blog!!<br /><br />The terminology Bayes de Luna uses is inferobasal wall (instead of posterior wall) to refer to that area of myocardium. <br /><br />However, the V7-V9 ischemic changes (Q wave or ST elevations), are equivalent to inverse changes in V1-V2 (tall R-wave, ST depression) --> all of which represent lateral infarcts based on new MRI evidence. <br /><br />http://eurheartj.oxfordjournals.org/content/36/16/959.long<br /><br />Please see Figure 6 in this article. <br /><br />RIP "Posterior MI" - hence we should probably stop using this term. We should decide if it's inferior (inferobasal) or lateral. Chances are it's lateral if you are looking at those leads. Anonymoushttps://www.blogger.com/profile/11457710253513487490noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-72724241992968476682014-05-24T10:24:06.443-05:002014-05-24T10:24:06.443-05:00Bayes de Luna just uses different terminology (pos...Bayes de Luna just uses different terminology (posterior = inferobasal). But this entity, however you call it, is clearly different from lateral MI (STE in I, aVL, V5, V6). It has ST depression in V1-V4 and ST elevation in V7-V9. It is in every way posterior. Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-78305124651593806872014-05-23T16:54:33.815-05:002014-05-23T16:54:33.815-05:00Greetings. I've just finished "The 12 Lea...Greetings. I've just finished "The 12 Lead ECG in ST Elevation Myocardial Infarction" by Bayes de Luna at al. and this was a nice case to test myself (fortunately, I did well). I'm sure you're aware that it was proposed to discontinue the term "posterior wall", especially when describing "STEMI equivalents" in V1-V2, cause these leads are thought to be anatomically opposed to lateral wall (and also because there isn't much of true posterior wall itself). Can you share your opinion on this briefly?Alexhttps://www.blogger.com/profile/06740825816423337497noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-57455307100064683292014-05-11T07:14:22.771-05:002014-05-11T07:14:22.771-05:00If hypotension is a concern, you can try fentanyl....If hypotension is a concern, you can try fentanyl. Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-17745071107322028352014-05-10T15:18:13.216-05:002014-05-10T15:18:13.216-05:00thank you Dr steve , what can we use as pain kille...thank you Dr steve , what can we use as pain killer in Rv MI instead of nitroglycerine other than morphia as long as we cant use nitroglycerine ?Dr emadhttps://www.blogger.com/profile/16674751839031264994noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-88121324043803900412014-05-10T09:02:58.535-05:002014-05-10T09:02:58.535-05:00A McConnell’s sign with an RV infarct - interestin...A McConnell’s sign with an RV infarct - interesting! Brooks Walshhttps://www.blogger.com/profile/16108633682893762401noreply@blogger.com