Anterior myocardial infarction is a term denoting ischemia and necrosis of the anterior myocardial wall due to occlusion of the left anterior descending artery. A sudden onset of chest pain that often radiates to the arm and neck accompanied by dyspnea, nausea, vomiting, weakness, and diaphoresis are some of the most common symptoms. Laboratory workup, electrocardiography (the V1-V4 precordial leads are specific for the anterior wall), and sometimes coronary angiography are essential steps to confirm myocardial infarction, but clinical suspicion is critical for an early diagnosis.
Despite the fact that myocardial infarction possesses a different pathogenesis in terms of its location and vessel involved, the clinical presentation is similar. In the case of anterior myocardial infarction, signs and symptoms stem from occlusion of the left anterior descending artery, the blood vessel responsible for supplying this part of the heart . Across many studies, chest pain is identified as the most frequent finding, typically described as a burning or squeezing sensation . It is seen in > 90% of patients   . Pain may be mild or quite severe and is further described as retrosternal, precordial, or radiating to various anatomical sites, such as the jaw, the neck, the shoulder, and arms, as well as posteriorly toward the interscapular region of the back   . Radiation of pain is usually unilateral but individuals in whom bilateral spread occurred are also reported  [3 . In the vast majority of cases, chest pain persists for more than 20 minutes . In addition to pain, other common complaints include nausea, vomiting, dyspnea, shortness of breath, diaphoresis, abdominal pain, fatigue, dizziness, and palpitations   . Interestingly, some studies highlight that multiple features are more commonly encountered among women compared to men, without an obvious explanation .
The diagnosis of a myocardial infarction must be made as soon as possible. For this reason, the physician must promptly obtain a detailed history and assess the signs that are present. To confirm the exact location of the infarction and its severity, it is necessary to perform specific laboratory studies that focus on "cardiac markers" and electrocardiography     . Troponins T and I, very specific markers of myocardial injury, become elevated within several hours after myocardial infarction and their highest values are estimated to be around 24 hours after the initial event . Creatine kinase myocardial band (CK-MB), initially used an equally important biomarker of cardiac injury , is now regarded as an unnecessary test due to its little value and accuracy . For this reason, troponin remains the key biochemical exam    . Electrocardiography is, perhaps, the crucial component of the workup in people in whom myocardial infarction is suspected. The diagnosis is made when the elevation of the ST segment at the J-point, ST depression, or inversion of the T wave is seen in 2 contiguous leads (with slightly different cutoff values for men and women)   . Anterior myocardial infarction is confirmed when these findings are shown on the precordial leads V1-V4 . In some patients, coronary angiography or other imaging studies of the heart can be used to further elucidate the severity of infarction .