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 40s who presented with intermittent left sided pleuritic chest pain for 3 days.
This ECG shows anterior ST elevation, but there was no anterior wall motion abnormality on echo - there was an inferolateral regional wall motion abnormality instead. Initial troponin was very high. He was found to have a 100% obtuse marginal occlusion. The ECG did not evolve over the next few days, suggesting that it was the patient's baseline ECG.