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ery, and to estimate the amount of myocardium at risk. Electrocardiographic Detection of Myocardial Infarction ? Coronary artery dominance, size and distribution of arterial segments, collateral vessels, and location, extent, and severity of coronary stenoses can also impact ECG manifestations of myocardial ischemia. Electrocardiographic Detection of Myocardial Infarction ? The ECG by itself is often insufficient to diagnose acute myocardial ischemia or infarction since ST deviation may be observed in other conditions such as acute pericarditis, LV hypertrophy, LBBB, Brugada syndrome, and early repolarization patterns. Also Qwaves may occur due to myocardial fibrosis in the absence of coronary artery disease, as in, for example, cardiomyopathy. Imaging Techniques ? The underlying rationale is that regional myocardial hypoperfusion and ischemia lead to a cascade of events including myocardial d