Prominent R-waves on leads V1 and V2, which might be the only manifestation of posterior myocardial infarction, do not enable the determination of the age of the infarction8-11.
Studies have shown that posterior chest leads improved the diagnostic accuracy of the ECG for the detection of posterior myocardial infarction (MI) 14, 15.
ST segment elevation posterior myocardial infarction was diagnosed in accordance with the clinical presentation and registered ECG changes (Figure 2).
Posterior myocardial infarction is caused by necrosis of the posterior, infra-atrial part of the left ventricle located beneath the atrioventricular sulcus.
Clinical presentation, risk factors and differential diagnosis of posterior myocardial infarction do not differ from other localizations of myocardial infarction.
Depending on the anatomy of coronary arteries and location of blood vessels, posterior myocardial infarction is commonly accompanied with inferior and/or lateral wall infarction, thus causing a large infarction area with a high risk of complications such as left ventricular dysfunction, right ventricular infarction, ischemic mitral regurgitation, arrhythmias and fatal outcome [8, 9].
It is assumed that posterior myocardial infarction accompanied by infarction of other localizations accounts for around 15-21%, while isolated posterior yocardial infarction is rarely found [10-12].