Liu et al listed changes in the electrocardiogram associated with atrial infarction. The presence of atrial infarction should be suspected in any case of acute myocardial infarction with any form of atrial arrhythmia. The authors are from Los Angeles County Harbor General Hospital and the University of California at Los Angeles.
Major criteria:
(1) (elevation of the P-Ta (PR) segment > 0.5 mm in V5 and V6) AND (reciprocal depression of the P-Ta segment in V1 and V2)
(2) (elevation of the P-Ta (PR) segment > 0.5 mm in I) AND (reciprocal depression of the P-Ta segment in II or III)
(3) (depression of the P-Ta segment > 1.5 mm in precordial leads) AND (depression of the P-Ta segement > 1.2 mm in I, II or III) AND (any form of atrial arrhythmia)
Minor criteria:
(1) abnormal P waves (M-shaped, W-shaped, irregular, notched)
The changes may be present for only a few hours or days and so can be missed.
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