Right ventricular MI

Right ventricular infarction causes ST elevation in V1 (> V2, or with ST depression in V2), lead III > II and right sided leads V3R-V6R.

Right ventricular infarction is easily missed, so a high index of suspicion is needed in all patients with inferior MI.

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ECG Library (22)

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In the ECGquest archives, this ECG has been tagged with: - Hypotension Syncope 12-Lead Sinus arrhythmia Sinus tachycardia High grade AV block Ventriculophasic sinus arrhythmia Acute Inferior MI Acute Posterior MI Right ventricular MI ECG Interpretation CC-BY-NC-SA
ECG Blog #168 (STEMI – complex AV Block – Laddergram – Calipers)

This ECG is from a middle-aged woman who presented with syncope and hypotension.

This ECG shows sinus tachycardia with inferior ST elevation and reciprocal ST depression in aVL. Also ST elevation in V1 and ST depression in V2-4. The most likely cause was acute inferoposterior MI due to proximal RCA occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST depression Inferior ST elevation Reciprocal ST depression Acute Inferior MI Acute Posterior MI Right ventricular MI ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG: Inferior Wall M.I. With Atrial Fibrillation or Atrial Flutter

This ECG is from a man in his 70s who presented with chest pain. He had a history of COPD.

This ECG shows massive inferior ST elevation with widespread ST depression. The most likely cause was an acute inferior infarct.

In the ECGquest archives, this ECG has been tagged with: - Right leads Hyperacute T waves Inferior ST elevation ST elevation in V4R Acute Inferior MI Right ventricular MI Dr Smith's ECG Blog CC BY-NC
Inferolateral STEMI: is there right ventricular MI also? Right sided ECG

This ECG is from a middle aged man who presented with 1 hour of chest pain. This was a right sided ECG where V1-6 are really V1R to V6R.

This ECG shows ST elevation in inferior and right sided leads, caused by a proximal RCA occlusion.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Hyperacute T waves Inferior ST elevation Lateral ST elevation Acute Inferior MI Right ventricular MI Dr Smith's ECG Blog CC BY-NC
Inferolateral STEMI: is there right ventricular MI also?

This ECG is from a middle aged man who presented with 1 hour of chest pain.

This ECG shows ST elevation in inferior and lateral leads, caused by a proximal RCA occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Peaked T waves Right ventricular MI Dr Smith's ECG Blog CC BY-NC
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician – repeat ECG pain free

This ECG is from a middle aged patient who presented with chest pain of uncertain duration. This was the repeat ECG when pain free

This ECG shows ST elevation in V1 has resolved. This was dynamic on serial ECGs. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Inferior ST elevation Peaked T waves Reciprocal ST depression ST elevation in V1 Right ventricular MI Dr Smith's ECG Blog CC BY-NC
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician – repeat ECG pain free

This ECG is from a middle aged patient who presented with chest pain of uncertain duration. This was the repeat ECG when pain returned.

This ECG shows ST elevation in V1, II, III and aVF with reciprocal ST depression in aVL. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Peaked T waves ST elevation in V1 Right ventricular MI Dr Smith's ECG Blog CC BY-NC
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician

This ECG is from a middle aged patient who presented with chest pain of uncertain duration.

This ECG shows ST elevation in V1 only. This was dynamic on serial ECGs. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Inferior ST elevation Inverted T waves Lateral ST elevation Right ventricular MI Dr Smith's ECG Blog CC BY-NC
Is there a Right Ventricular MI in addition to Infero-postero-lateral MI?

This ECG is from a woman in her 40s who presented with sudden onset chest pain.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Serial 12-lead Excessive discordant ST elevation Pacemaker spikes ST elevation in V1 Wide QRS Acute Inferior MI Right ventricular MI Dr Smith's ECG Blog CC BY-NC
A 50-something with h/o coronary bypass has chest pain and a ventricular paced rhythm – 3, 16 min later

This ECG is from a man in his 50s who presented with chest pain on a background of previous CABG and dual chamber pacemaker. This was the repeat ECG 16 min after arrival.

This ECG shows a ventricular paced rhythm with excessive discordant ST elevation in III and aVF, and ST depression in aVL. The cause was an inferior and right ventricular infarction.