Myocardial abnormalities underlying persistent ST-segment elevation after anterior myocardial infarction

Abstract

Persistent ST-segment elevation after anterior myocardial infarction is related to a larger extent of transmural necrosis and persistent microvascular damage as assessed by contrast-enhanced magnetic resonance imaging. However, the presence of microvascular damage seems to be the most powerful determinant of persistent ST-segment elevation.

Electrocardiographic evolution in patients with hypertrophic cardiomyopathy who develop a left ventricular apical aneurysm

“…[24] Persistent ST-segment elevation probably indicates the presence of persistent microvascular damage, but its fundamental mechanism remains to be clarified. [25] A C C E P T E D M A N U S C R I P T…”

Focused Cardiac Ultrasound for the Detection of a Ventricular Aneurysm

“…It is typically located on the anterior wall in the territory of the left anterior descending artery. It occurs in 5% of patients with a recent ST-segment elevation myocardial infarction,but has also been reported in patients with hypertrophic cardiomyopathy and Chagas disease 1–3…”

Chameleons

“…32,33 Although the exact mechanism for its persistence has yet to be elucidated, at least one study has shown that continued ST-segment elevation may be a further marker of extensive transmural necrosis and microvascular damage. 34 Because of the typical location of ventricular aneurysm postinfarction, ST-segment elevation in this setting is most commonly in the anterior leads. 35 Historical factors, such as known recent AMI, should help provide the emergency physician some clues in distinguishing an acute STEMI from ventricular aneurysm.…”