gms | German Medical Science

33. Internationale Konferenz für Elektrokardiographie

Internationale Konferenz für Elektrokardiographie

Atrial Infarction. Possible Significance

Meeting Abstract

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  • corresponding author presenting/speaker R. Grigore - Country Hospital, Galati, Rumänien
  • C. Sutescu - Central Diagnosis N. Kretzulescu, Bucuresti, Rumänien

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice088

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Veröffentlicht: 8. Februar 2007

© 2007 Grigore et al.
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The retrospective analysis of the ECGs in 100 cases of acute VMI allows us to trace out some cases of AI which we present here.

Case 1 (a female of 83 years old with anterior acute VMI) presents the elevation of the atrial repolarization with 0.4-0.5 mm in I, aVL and V4-V6. The atrial extrasystols with qR aspects in II, III, aVF and QS aspects in I, aVL and V1-V6 can indicate an AI.

Case 2 is a female of 66 years old, with acute coronarian syndrome, atrioventricular block of Ist degree and left bundle branch block. The atrial depolarization with rs in V1-V2 and the atrial repolarization elevation with 0.5 - 1 mm in I, aVL and V1-V2, on the repeated ECG, with atrial QS in V1-V2, gives the diagnosis of AI, suggestive for concomitant acute VMI masked by LBBB and subsequently confirmed on ECG without BRS.

Case 3 is a male of 66 years old with acute inferior VMI with Q wave and acute anteroapical and lateral VMI non Q concomitant with AI proved by the atrial repolarization elevation with 0.5 mm in II, III and aVF had evolved with ventricular extrasystoles and ventricular tachycardia, acute pulmonary edema, cardiogenic shock and death. The severe evolution was due to multiple VMIs confirmed by autopsy.

Case 4 is a female of 74 years old with old anteroseptal VMI and acute inferior VMI, who had at onset recurrence syncopes, episodes of atrial fibrilation with atrioventricular block, episodes of sinoatrial block of IIIrd degree with rhythm of junctional escape and episodes of atrioventricular block of IIIrd degree with rhythm of junctional escape. In the episodes of atrioventricular block with transient atrial electrical activity the P wave have the repolarization elevation of 0.2-0.3 mm in II, III and aVI, which is an expression of AI. Right ventricular temporary stimulation with external pacemaker was done in the critical phase. The subsequent evolution was favorable.

Remarks: Not always the AIs concomitant with acute VMI have severe clinical evolutions.