Overview
Acute posterior myocardial infarction (MI) is a specific type of ST-elevation myocardial infarction (STEMI) characterized by ST-segment elevation in the inferior leads of the electrocardiogram (ECG), which can sometimes be transient. Patients with transient STEMI or spontaneous resolution (SpR) of ST-segment elevation present a management dilemma regarding the timing of reperfusion therapy 1.Diagnosis
Transient ST-elevation myocardial infarction (STEMI) or spontaneous resolution (SpR) of ST-segment elevation on ECG 1.Management
Deferral of angiography and revascularization within 24-48 hours may be reasonable for patients with transient STEMI and is associated with similar or potentially better outcomes compared to immediate angiography 1.
Further randomized trials are needed to determine optimal pharmacological and invasive strategies for this cohort 1.Key Recommendations
For patients with transient STEMI, deferral of angiography and revascularization within 24-48 hours is a reasonable approach and may be associated with similar or better outcomes than immediate angiography. (Evidence: Moderate)
Further randomized trials are required to elucidate the best pharmacological and invasive strategies for patients with transient STEMI. (Evidence: Moderate)References
1 Farag M, Peverelli M, Spinthakis N, Gue YX, Egred M, Gorog DA. Spontaneous Reperfusion in Patients with Transient ST-Elevation Myocardial Infarction-Prevalence, Importance and Approaches to Management. Cardiovascular drugs and therapy 2023. link