ECG 1. The ECG above, belongs to a 56 years old man who had experienced acute (now OLD) inferoposterior myocardial
infarction. Both his RCA and circumflex coronary arteries were stented at the time of acute infarction.

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ECG 2. The ECG above belongs to a 60 years old man and shows OLD inferoposterior myocardial infarction.
His LAD and RCA were normal during coronary arteriography. A dominant circumflex was the infarct-related artery.

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ECG 3. Old inferoposterior myocardial infarction due to proximal circumflex (Cx) occlusion.

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ECG 4a. Old inferoposterior myocardial infarction. The patient's coronary angiography showed 100% stenosis in Cx,
95% stenosis in RCA and a normal LAD.

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ECG 4b. The same patient's ECG, 2 years later. The negative T waves in inferior leads have now become positive.

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ECG 5a. The ECG above belongs to a 46 years-old man with mild mitral stenosis and frequent attacks of palpitation.
At first glance, the q waves in inferior leads and tall R waves in lead V1 suggest a diagnosis of old inferoposterior
myocardial infarction. The delta waves in some patients with WPW syndrome may imitate q waves suggesting old
myocardial infarction.
In the above ECG, lead V3 shows a giant delta wave, while leads V4 and aVL show subtle delta waves.

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ECG 5b. The above ECG was recorded during one of his palpitation attacks.

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ECG 5c. Electrophysiologic study showed left posterolateral accessory pathway in this patient.
The above ECG was recorded after ablation of the accessory pathway.
Inferior leads do not show q waves anymore. No more suggestion of old inferoposterior myocardial infarction.
Lead V3, V4 and aVL also do not show delta waves any more.

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ECG 6. Above is an ECG from a 70 years-old woman who had experienced acute inferoposterior wall myocardial infarction
3 years ago. Coronary angiography showed total occlusion of non-dominant Cx artery. Her LAD and RCA were normal.
Because of the low voltage in limb leads, q waves in inferior leads are not easily discernible.
Leads V1 and V2 show high amplitude R waves.

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ECG 7. Above is an ECG from a 55 years-old man who had experienced acute inferoposterior wall myocardial infarction
2 months ago. Coronary angiography showed simultaneous thombotic occlusions of both the RCA and Cx arteries.
Inferior leads show QS complexes and negative T waves.

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ECG 8a. Above is an ECG from a 61 years-old man. It was recorded at a standard calibration of 10 mm/mV.
He had experienced inferoposterior wall myocardial infarction due to total occlusion of the right coronary artery (RCA) in the past.
q waves in inferior leads are seen.
Leads V1 and V2 show high amplitude R waves (mirror-image of Q waves).
Leads V1 to V3 show ST elevation (mirror-image of ST depression) and tall T waves (mirror image of negative T waves).

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ECG 8b. The ECG above belongs to the same patient.
It was recorded immediately after the ECG 8a, but at a calibration of 20mm/mV.

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ECG 9. The ECG above belongs to a 60 years-old hypertensive man.
He has 3-vessel (extensive) coronary artery disease.
He had experienced acute inferoposterior myocardial infarction 9 years ago.
Inferior leads show Q waves, negative T waves and minimal ST elevation.
Relatively tall R wave in lead V1 and tall T waves in leads V2-V3 are compatible with old posterior myocardial infarction.
Extensive coronary artery disease also resulted in ST depression in leads V4 to V6.

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