Ischemic Heart Disease

Localization

• Septal → V1, V2

• Anteroseptal → V1-V3

• Anterior → V1-V4, 5, or 6

• Anterolateral → V1-6, I, avL

• Inferior → II, III, avF

• Lateral → I, avL

• Apical → V5, V6

• Posterior → V1, V2

Ischemia

• Manifestation by symmetrical inversion of T wave with normal ST segment

Sub-endocardial Injury

• Flat/down sloping ST segment with J point depressed by at least 1mm

Sub-epicardial injury

• Upward, convex, coved ST segment elevation

• J point elevated at least 1mm in limb leads and 2mm in precordial leads

Non-Q wave infarction

• Non-transmural

• Decrease amplitude and size of QRS: lose R wave amplitude

• Have sub-endocardial pattern in acute phase

Q wave (trans-mural) infarction

• Large Q waves: >0.04 seconds in width and more than or equal to a quarter of the QRS height

• Have sub-epicardial injury pattern in acute phase