Summary
A method for localizing smaller infarcts into each of 12 left ventricular and septal segments is presented, along with criteria for sizing these infarcts from trival scars 1 cm in diameter to large life-threatening lesions of 8 cm in diameter. The clinical utility of being able to size infarcts with 85–90% reliability as shown here is clear cut. Lesions of 3 cm in diameter or smaller are associated with normal or near normal ventricular function and reserve. Myocardial infarcts 4–6 cm in diameter are associated with moderate ventricular disability. Lesions 7–9 cm in diameter involve 30% or more of the ventricular mass and are associated with cardiac insufficiency, pump failure, and/or low cardiac reserve.
Scars 1 and 2 cm in diameter are non-specific and can occur with inflammatory myocardial processes as well as coronary artery disease, but do not occur in the normal population. Scars 3 cm in diameter or larger are highly correlated with myocardial infarction.
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References
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Selvester, R.H., Wagner, J.O., Rubin, H.B. (1971). Quantitation of Myocardial Infarct Size and Location by Electrocardiogram and Vectorcardiogram. In: Snellen, H.A., Hemker, H.C., Hugenholtz, P.G., Van Bemmel, J.H. (eds) Quantitation in Cardiology. Boerhaave Series for Postgraduate Medical Education, vol 8. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-2927-8_4
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DOI: https://doi.org/10.1007/978-94-010-2927-8_4
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