Abilities and Limitations of Precordial Mapping in Acute Myocardial Infarction

Abstract

In more than 90% of all patients acute myocardial infarction can be recognized by the 12 leads standard ECG. Only in few cases is it necessary to increase the number of electrodes for diagnostic purposes as, for instance, in dominant right heart infarction. For detailed analysis of the electrocardiographical development of myocardial infarction and for the evaluation of therapeutical influence on infarct size, however, multiple leads exceeding the number of 12 standard leads have shown themselves to be useful. The first investigations concerning these topics were done in animal experiments by Maroko, Braunwald and co-workers in the late sixties using epicardial leads [1, 2, 3] and showed the good correlation between ST-segment elevation after LAD occlusion, CK content of myocardium and histological findings in the ischemic area. The close correlation between epicardial and precordial ECG changes in anterior myocardial infarction made this method also applicable to man [4].