Post-infarct lateral extension—Brody effect or stent thrombosis?

It is a common dilemma in determining whether to restudy a patient who has just received a stent in the left anterior descending artery for an anterior ST-elevation myocardial infarction, particularly when the ST-segments rise again and extend to lateral precordial leads. As a precaution, such patients frequently undergo repeat coronary angiography, which usually confirms stent patency. It appears that a dilated post-infarct left ventricle, affected by reperfusion injury, produces a Brody effect that mimics lateral infarction. The increase in intracavity blood volume renders the heart more electrically conductive and radially amplifies electrocardiographic signals.