ECG of a patient with acute inferior myocardial infarction.

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Presentation transcript:

ECG of a patient with acute inferior myocardial infarction. ECG of a patient with acute inferior myocardial infarction. (A) There is ST elevation in leads II, III, aVF, V5, and V6, and ST depression in I, aVL, V1–V3. Several criteria implicate the right coronary artery as the infarct related artery including: (1) greater ST elevation in lead III than in II, (2) greater ST depression in aVL than I, and (3) a S:R ratio >3 in aVL. There is also evidence for a larger than expected inferior infarction with extension to the lateral aspect of the cardiac apex (ST elevation in V5 and V6) and injury to the posterior wall (ST depression in leads V1–V3). (B) Coronary angiography confirms complete occlusion of the right coronary artery. (C) After primary angioplasty, a dominant right coronary artery with a large posterolateral branch is revealed, which is in agreement with ECG findings of posterior and lateral wall infarct extension. Y Birnbaum, and B J Drew Postgrad Med J 2003;79:490-504 Copyright © The Fellowship of Postgraduate Medicine. All rights reserved.