Large mixed transmural / nontransmural apical-anterior-septal MI (arrows) involving 8/25 segments with moderate-to-severe ischemia in the residual myocardium, in the anterior wall, and in the septum (small lines) (7/25 segments) (LAD territory).
Comment:
Fixed and reversible changes extending to the apical inferior and the apical lateral segments is most likely an effect of wrap-around LAD supply.
LAD infarcts in younger men are often extensive and severe, and most likely due to an acute occlusion (thrombosis) on moderate or even mild arteriosclerotic plaques.When atherosclerosis develops more gradually, collaterals develop, so that when total occlusion occurs, a less severe MI emerges.
