High Anterior Myocardial Infarction

T HE most widely accepted electrocardiographic classification of myocardial infarction is that proposed by Wilson and his associates.' They classified myocardial infarction "on the basis of the leads in which characteristic modifications of both the QRS deflections and the T complexes appear and have been given names indicative of the parts of the ventricular wall known, or thought, to be involved." Eight types of infarction were recognized: anteroseptal, anterolateral, extensive anterior, high anterolateral, plain posterior, posterolateral, postero-inferior or posteroseptal and high posterolateral. Another classification, based on the spatial situation of the area of body surface in which infarction Q waves are found ("Q area"), has been recently proposed by Grant and Murray.2 After analysis of 115 cases of myocardial infarction, the following 5 general locations of the Q area were described: strictly anterior, anterolateral, inferior or diaphragmatic, strictly posterior, and high lateral. The conventional 12-lead electrocardiogram explores a given number of positions on the body surface, namely, the roots of the right arm, left arm, left leg, and the 6 precordial positions. If the electrocardiographic manifestations of infarction should arise outside these positions, characteristic changes of infarction will not be reflected in the electrocardiogram.