Atrial infarction

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Myocardial infarction
ICD-10 I21-I22
ICD-9 410
DiseasesDB 8664
MedlinePlus 000195
eMedicine med/1567  emerg/327 ped/2520

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Atrial infarction is ischemic necrosis of the upper chamber of the heart (the atrium). It is a disease that has not been well studied.[1]

Incidence

In autopsy studies, the incidence is highly variable ranging from 0.7% to 42%. The largest series to date involved 182 patients, and the incidence in that study was 17%.

Pathophysiology

The right atrium is involved five times as often as the left, with the auricle the predominant site in either atria.

EKG Findings:

The following may be present: supraventricular arrhythmias, atrial rupture, hemodynamic compromise from loss of atrial "kick," and thromboembolic phenomena.

Electrocardiographic diagnostic criteria [2] [3] [4]

Major criteria

  • PTa-segment elevation >0.5 mm in leads V3 and V6 with reciprocal depression of PTa segments in V1 and V2 leads.
  • PTa-segment elevation >0.5 mm in lead I with reciprocal depressions in leads II and III.
  • PTa-segment depression >1.5mm in precordial leads and 1.2mm in leads I, II and III, associated with any atrial arrhythmia.

Minor criteria

  • Abormal P-waves, flattening of P-wave in M, flattening of P-wave

Echocardiography

Transesophageal echocardiography may demonstrate abnormalities.

References

  1. Lazar, E.J. (1988). "Atrial infarction: diagnosis and management". Am Heart J. 116 (4): 1058–63. Retrieved 2007-10-10. Unknown parameter |coauthors= ignored (help)
  2. Liu CK, Greenspan G, Piccirilio RT. Atrial infarction of the heart. Circulation 1961; 23: 331-8.
  3. Mayuga RD, Singer DH. Atrial infarction: clinical significance and diagnostic criteria. Pratical Cardiol 1985; 11: 142-60.
  4. Mayuga RD, Singer DH. Atrial infarction: clinical significance and diagnostic criteria. Pratical Cardiol 1985; 11: 142-60.

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