Subendocardial injury in anterolateral leads (INJAL) is a type of electrocardiogram (ECG) finding that indicates a possible lack of blood flow and oxygen to the heart muscle in the subendocardial layer of the anterolateral region, which includes leads V3-V6, I, and aVL.
INJAL can be asymptomatic, meaning that the individual may not experience any noticeable symptoms. However, some individuals may experience symptoms such as chest pain, shortness of breath, palpitations, and dizziness.
When reviewing an ECG for INJAL, it is important to pay attention to the presence of ST segment depression in the anterolateral leads. Other things to pay attention to include the presence of T wave inversions, and the morphology of the QRS complexes.
If INJAL is suspected, further testing such as stress testing, echocardiography, or cardiac catheterization may be recommended to determine the extent of the injury and if there is an underlying cardiovascular condition that requires treatment.