[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-657668-105":59,"doc-detail-657668-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","new-heart-wall-terminology-and-new-electrocardiographic-classification-of-q-wave-myocardial-infarction-based-on-correlations-with-magnetic-resonance-imaging","New Heart Wall Terminology and New Electrocardiographic Classification of Q-Wave Myocardial Infarction Based on Correlations With Magnetic Resonance Imaging","","Editorial discussing how long-standing electrocardiographic dogmas about posterior wall infarction and the origin of an R wave in V1–V2 have shaped myocardial infarction classification. It reviews historical concepts (posterior vs inferior labeling, Perloff’s “strict posterior” vector idea, and lateral-high findings) and contrasts them with newer evidence from radionuclide imaging and magnetic resonance correlations. The text argues that updated terminology and ECG classification are needed to align clinical ECG patterns with imaging anatomy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/new-heart-wall-terminology-and-new-electrocardiographic-classification-of-q-wave-myocardial-infarction-based-on-correlations-with-magnetic-resonance-imaging/657668/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/new-heart-wall-terminology-and-new-electrocardiographic-classification-of-q-wave-myocardial-infarction-based-on-correlations-with-magnetic-resonance-imaging/657668.png","ImageObject",300,407,{"name":92,"@type":93},"Himbo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-10-26",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What electrocardiographic dogmas does the editorial question?","Question",{"text":112,"@type":113},"It challenges the belief that a posterior left-ventricular wall exists in a specific way on ECG, and that post-infarction patients with a tall R wave in V1–V2 necessarily have posterior wall infarction.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the “strict posterior wall” concept explain an R wave in V1–V2?",{"text":117,"@type":113},"It proposes that necrosis from the strictly posterior wall travels from back to front, producing an RS pattern in V1–V2, interpreted as a manifestation of a Q-wave registered toward the back.",{"name":119,"@type":110,"acceptedAnswer":120},"What evidence is cited to dispute the posterior origin of the R wave in V1?",{"text":121,"@type":113},"The editorial states that radionuclide imaging studies and magnetic resonance evidence indicate that the infarct generating an R wave in V1 is lateral rather than posterior, despite continued textbook assumptions.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},657668,1792986174,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":143},687197100911,"https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697","EDITORIAL  \nNew Heart Wall Terminology and New Electrocardiographic Classification of Q-Wave Myocardial Infarction Based on Correlations With Magnetic Resonance Imaging  \nAntoni Bayés de Luna  \nInstitut Català de Ciències Cardiovasculars, Hospital de Sant Pau, Barcelona, Spain  \nThe End of Some Dogmas  \nA dogma is any point of doctrine that is believed tobe unquestionable and certain. In this sense, in electrocardiographic diagnosis, the dogma that there was a posterior wall of the left ventricle and that post-infarction patients in which a tall R wave appeared in V1 through V2 had an infarction of that wall was considered certain and unquestionable. Besides, the presence of QS morphology in VL was considered as a manifestation of a high lateral infarction. Lastly, it was believed, ever since Myers et al1-3 anatomopathologic correlation study, in the 1940s, that the localization of a Q wave infarction was as follows: Q in V 1 through V2 indicated septum infarction, V3 through V4 anterior, V5 through V6 low lateral, I through VL high lateral, and II, III, VF inferior.  \nHow the Dogma That the Posterior Wall Existed and That a Posterior Infarct Originated an RWave in V1 Through V2, the High Lateral Infarction Led to the QS Morphology  \nin VL, and the Anteroseptal Infarct Generated a Q Wave in V1 Through V4 Was Generated and Perpetuated  \nIn 1940s, just after the implementation of the precordial leads, it was generally considered that there was an anterior infarct (Q in I and VL, and precordials), and a posterior one (Q in II, III, VF) .4 In the 1950s, some authors5 indicated that the posterior, which was the one that was in contact with the diaphragm, would be better called inferior or diaphragmatic. When Perloff6 coined the concept of a strict posterior infarct to explain the RS morphology in V 1 through V2, the expression was considered fortunate because it explained what was clear for this electrocardiographic patent, since this necrosis  \nCorrespondence: Dr. A. Bayés de Luna.  \nInstitut Català Ciències Cardiovasculars. Hospital de Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España.  \nE-mail: [abayes@csic-iccc.org](abayes@csic-iccc.org)  \naffected the basal part of the inferior wall that was thought to go always upwards and that, for this reason, was denominated the authentic or strict posterior wall. He was then correct to think that the infarct of what was called the strictly posterior wall originated a vector of necrosis that travelled from the back to the front and that was manifested by an RSinV1 through V2, an expression of the Q wave that was registered in the back (Figure 1A) . Naturally, if the infarct only occupied the medial and apical part of the wall that rests on the diaphragm, the authentic inferior wall originated a Q wave in II, III, VF that was considered as an expression of an inferior wall infarctionand, therefore, the infarct occupied the inferior wall and the authentically posterior corresponded to an inferoposterior infarct (Q in II, III, VF + RS in V 1 through V2) (Figure 1A) .  \nAlthough some authors7 manifested that the anatomopathological correlation that the R on V 1 was more easily explained by a lateral infarct tan a posterior one, their studies had no echo or were obscured by the prestige of Perloff and the journal in which he published his paper, as well as by the enormous capacity that humans have to transmit wrong information when we believe it to be an article of faith. Even recently there has been evidence, in an age of radionuclide imaging studies8 and magnetic resonance,9,10 that the infarct that originates a R wave in V1 is lateral and not posterior. In spite of that, in all of the textbooks, including ours, task forces and guidelines 11-18 have taken for granted the fact that the posterior infarction was the lesion that generated a tall R wave in V1. It was never questioned whether Perloff could be wrong, probably because their research had never been cast in doubt. All of th","cbCaiot6q9IKqT6g","https://ap.wps.com/l/cbCaiot6q9IKqT6g","pdf",672821,"English","# Editorial overview\n## Historical ECG dogmas and posterior wall localization\n## Perloff’s strict posterior concept and RS in V1–V2\n## Inferior and inferoposterior patterns\n## Challenges from imaging and new electrocardiographic classification\n## Figure 1: Conceptual infarction zones and ECG patterns","[{\"question\":\"What electrocardiographic dogmas does the editorial question?\",\"answer\":\"It challenges the belief that a posterior left-ventricular wall exists in a specific way on ECG, and that post-infarction patients with a tall R wave in V1–V2 necessarily have posterior wall infarction.\"},{\"question\":\"How did the “strict posterior wall” concept explain an R wave in V1–V2?\",\"answer\":\"It proposes that necrosis from the strictly posterior wall travels from back to front, producing an RS pattern in V1–V2, interpreted as a manifestation of a Q-wave registered toward the back.\"},{\"question\":\"What evidence is cited to dispute the posterior origin of the R wave in V1?\",\"answer\":\"The editorial states that radionuclide imaging studies and magnetic resonance evidence indicate that the infarct generating an R wave in V1 is lateral rather than posterior, despite continued textbook assumptions.\"}]","New Heart Wall Terminology and New Electrocardiographic Classification of Q-Wave Myocardial Infarction Based on Correlations With Magnetic Resonance Imaging | PDF",18]