An acute Inferior MI features signs of coronary occlusion (hyperacute T waves, ST elevation, Q formation) in the inferior leads (II, IIII, aVF) along with reciprocal changes in aVL +/- lead I. There may also be right ventricular infarction or posterior infarction. The culprit can be any of the three main coronary arteries, but is usually a dominant RCA occlusion. Less often it is a dominant left circumflex, or occasionally it is a wraparound LAD (anterior and inferior infarction).
See also: Basic STEMI localisation
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This ECG is from a man in his 60s who presented with chest pain for 48h with diaphoresis.
This ECG shows inferior ST elevation with reciprocal depression in aVL and I. ST depression in V2-4. Deep Q waves inferior leads and tall R waves V1-3. The cause was a completed infarction with 2 likely culprits (RCA and circumflex).
This ECG is from a man in his 60s who presented with chest pain radiating to the back and nausea/vomiting. He had a history of previous MI and stents.
This ECG shows inferior ST elevation (straightened ST segments) without reciprocal changes, with terminal QRS distortion in inferior leads. The cause was an inferior MI with some posterior involvement.