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.
- Thaler, MS (2018) - The Only EKG Book You'll Ever Need, 9th edn, Lippincott Williams and Wilkins
- (2015) - ECG Interpretation Made Incredibly Easy!, 6th edn, Lippincott Williams & Wilkins
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- Strong Medicine - Intro to EKG Interpretation - Myocardial Infarctions (Part 2 of 2), (Accessed: 05/09/2019)
- alidaroxana12 (2011) - CCRN Study Tip: Where MI's are on EKG's, (Accessed: 08/09/2019)
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.
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.
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.
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.