Posterior Infarction or Normal Variant

Report:

Sinus rhythm 60/min

Probable posterior infarction

Comment:

This trace is more abnormal than the preceding one, with flat or low-amplitude T waves in the inferolateral leads. However, the heart was normal echocardiographically and on autopsy. The patient had a massive hæmorrhage from a known, previously treated, cerebral AV malformation.

While CVAs can mime myocardial infarction and, indeed, cause myocardial damage in their own right through catecholamine release, I have never heard of a mime suggesting posterior infarction. This case is probably a normal-variant early transition with T wave changes thrown in by the CVA.

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