Anterior Myocardial Infarction - PubMed

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.

2024 Feb 12.

Myocardial infarction (MI) continues to be the leading cause of death globally. It involves irreversible necrosis of the cardiac muscle due to reduced blood supply caused by the occlusion of coronary arteries. MI represents a significant but preventable contributor to morbidity and mortality rates.

Clinically, the diagnosis of myocardial infarction is established when there is an elevation in cardiac biomarkers, coupled with evidence of acute myocardial ischemia, which can include angina, electrocardiogram (ECG) changes, or echocardiographic evidence of wall motion abnormalities. Anterior wall myocardial infarction (AWMI) occurs when there is a reduction in blood supply to the anterior wall of the heart, resulting from occlusion of the left anterior descending artery (LAD).

Anterior myocardial infarction is associated with higher mortality and morbidity than other acute myocardial infarctions locations. It is linked to increased in-hospital mortality, greater reduction in left ventricle ejection fraction, and a higher incidence of congestive heart failure compared to infarctions occurring in other areas of the heart.

Anterior myocardial infarction can be classified into different categories based on the anatomical location of the occlusion in the left anterior descending (LAD) artery. These categories are as follows:

1. Proximal LAD: Proximal to first septal perforator. On ECG findings, ST elevation is evident in leads V1-V6, I, and aVL. It may also present as a new bundle branch block or a fascicular block.

2. Mid-LAD: Distal to the first septal perforator but proximal to the first large diagonal branch. ECG findings reveal ST elevation in leads V1-V6, I, and aVL. Bundle branches are usually preserved.

3. Distal LAD: Distal to large diagonal or large diagonal itself. ECG findings show ST elevation in leads V1-V4, I, aVL, V5, or V6.

Disclosure: Kamna Bansal declares no relevant financial relationships with ineligible companies.

Disclosure: Meghana Gore declares no relevant financial relationships with ineligible companies.

Disclosure: Muriam Afzal declares no relevant financial relationships with ineligible companies.

Disclosure: Pirbhat Shams declares no relevant financial relationships with ineligible companies.

Disclosure: Poorna Nalabothu declares no relevant financial relationships with ineligible companies.

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