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Atrial Myocardial Infarction

Michael R. Jones, MD
Arch Intern Med. 1984;144(3):573-574. doi:10.1001/archinte.1984.00350150181038.
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The antemortem diagnosis of atrial myocardial infarction can be made only with ECG. Nonetheless, ECG findings in atrial infarction are frequently overlooked by electrocardiographers. I review herein the ECG criteria for the diagnosis of atrial infarction and their clinical usefulness in establishing a diagnosis.

REPORT OF A CASE  A 59-year-old man was brought to our cardiac catheterization laboratory for coronary angiography because of a four-month history of angina pectoris (New York Heart Association class IV) that had persisted despite medical management with β-blockers, nitrates, and nifedipine. After coronary angiography, the patient had chest pain associated with hypotension, sinus bradycardia, periods of complete atrioventricular block, and one episode of ventricular fibrillation. Following treatment with DC cardioversion, dopamine hydrochloride, and a temporary pacemaker, his condition rapidly stabilized. An ECG demonstrated marked elevation of the P-Ta segments in leads II, III, and aVF consistent with atrial infarction. There was no ECG


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