Acute Myocardial Infarction of the Posterior Wall of the Left Ventricle: Clinical Polymorphism and Diagnostic Features

The article presents an analytical review of the clinical, anatomical, and pathophysiological features of acute posterior wall myocardial infarction of the left ventricle. Particular attention is paid to its clinical polymorphism and atypical presentations, including predominant dyspeptic and autonomic symptoms. The mechanisms of vagal reactions, the role of the Bezold–Jarisch reflex, and coronary blood supply characteristics underlying the clinical picture are examined. Diagnostic challenges of standard electrocardiography are analyzed, and the importance of recording additional posterior leads (V7–V9) is substantiated. Persistent hiccups are highlighted as a potential ischemic symptom and marker of diaphragmatic myocardial involvement. Emphasis is placed on early recognition of atypical manifestations to ensure timely initiation of reperfusion therapy. Keywords: acute myocardial infarction, posterior wall of the left ventricle, posterior-diaphragmatic infarction, hiccups, Bezold–Jarisch reflex, ECG V7–V9.