Differential Diagnosis for Posterior MI

• Single most likely diagnosis
  • Acute posterior myocardial infarction (MI): This is the most likely diagnosis given the presentation of "posterior MI". The posterior wall of the heart is supplied by the posterior descending artery, which is often a branch of the right coronary artery. An occlusion in this artery can lead to a posterior MI.
• Other Likely diagnoses
  • Inferior myocardial infarction: The inferior wall of the heart is also supplied by the right coronary artery, and an inferior MI can sometimes present with similar symptoms to a posterior MI.
  • Right ventricular infarction: The right ventricle is also supplied by the right coronary artery, and an infarction here can present with similar symptoms to a posterior MI.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Pulmonary embolism: While not directly related to the coronary arteries, a pulmonary embolism can present with chest pain and electrocardiogram (ECG) changes that might be mistaken for a posterior MI.
  • Aortic dissection: This is a life-threatening condition where the inner layer of the aorta tears, and can present with chest pain that might be mistaken for a MI.
• Rare diagnoses
  • Cardiac sarcoidosis: This is a rare condition where granulomas form in the heart, and can cause symptoms similar to a MI.
  • Myocardial bridging: This is a rare condition where a portion of a coronary artery dives into and is surrounded by the myocardium, which can cause symptoms similar to a MI.
  • Coronary artery spasm: This is a rare condition where the coronary arteries spasm, reducing blood flow to the heart and causing symptoms similar to a MI.