UMEM Educational Pearls

Posterior Myocardial Infarctions (PMI)

- Posterior myocardial infarctions (PMI) are different than typical ST-elevation MI; the ECG findings include: septal & anterior ST-segment depression, dominant tall/broad R waves, and upright T waves.

- In a study among 117,739 subjects with STEMI, 824 with PMI were more likely to present with cardiac arrest, cardiogenic shock, and congestive heart failure.

- The median time from arrival ECG to revascularization with PCI was longer among subjects with PMI.

- The median time from arrival ECG to systemic thrombolysis was also longer among subjects with a PMI.

- Increased awareness and recognition of PMI is needed to improve reperfusion times among this subpopulation with STEMI.



Waldo S, et al. Reperfusion times and in-hospital outcomes among patients with an isolated posterior myocardial infarction. Am Heart J 2014;167:350-354.