Correlation of Electrocardiogram and Regional Cardiac Magnetic Resonance Imaging Findings in ST-Elevation Myocardial Infarction: A Literature Review

Irina Rinta-Kiikka*, Suvi Tuohinen, Pertti Ryymin, Petteri Kosonen, Heini Huhtala, Anton Gorgels, Antonio Bayes de Luna, Kjell Nikus

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Patients with acute ST-elevation myocardial infarction (STEMI) benefit substantially from emergent coronary reperfusion. The principal mechanism is to open the occluded coronary artery to minimize myocardial injury. Thus the size of the area at risk is a critical determinant of the patient outcome, although other factors, such as reperfusion injury, have major impact on the final infarct size. Acute coronary occlusion almost immediately induces metabolic changes within the myocardium, which can be assessed with both the electrocardiogram (ECG) and cardiac magnetic resonance (CMR) imaging. Methods: The 12-lead ECG is the principal diagnostic method to detect and risk-stratify acute STEMI. However, to achieve a correct diagnosis, it is paramount to compare different ECG parameters with golden standards in imaging, such as CMR. In this review, we discuss aspects of ECG and CMR in the assessment of acute regional ischemic changes in the myocardium using the 17 segment model of the left ventricle presented by American Heart Association (AHA), and their relation to coronary artery anatomy. Results: Using the 17 segment model of AHA, the segments 12 and 16 remain controversial. There is an important overlap in myocardial blood supply at the antero-lateral region between LAD and LCx territories concerning these two segments. Conclusion: No all-encompassing correlation can be found between ECG and CMR findings in acute ischemia with respect to coronary anatomy.
Original languageEnglish
Pages (from-to)509-523
JournalAnnals of Noninvasive Electrocardiology
Issue number6
Publication statusPublished - Nov 2014


  • ECG
  • cardiac MR
  • acute myocardial infarction
  • coronary artery territories

Cite this