What leads show a right-sided MI?

Right ventricular infarction is suggested by: ST elevation in V1. ST elevation in lead III > lead II.

Which ECG leads show posterior wall MI?

In patients presenting with ischaemic symptoms, horizontal ST depression in the anteroseptal leads (V1-3) should raise the suspicion of posterior MI. Posterior infarction is confirmed by the presence of ST elevation and Q waves in the posterior leads (V7-9).

When do you use a right-sided 12 lead?

All patients with chest pain should receive a 12-lead ECG early in the patient encounter. When the patient is suffering acute inferior STEMI a right-sided 12-lead ECG can help to identify right ventricular infarction. Be careful with nitroglycerin in the setting of right ventricular infarction.

Why is nitro bad for right-sided MI?

As discussed above, nitroglycerin functions to decrease preload and will induce further hypotension and possible arrest in patients suffering from a right ventricular MI, volume depletion, or in those who have recently used erectile dysfunction medications.

How is right-sided MI treated?

It is important to recognize the signs of a right ventricular infarct because treatment differs significantly between patients with an RVI and those with other infarct sites. The traditional field treatment for an MI is aspirin and oxygen, with nitroglycerin and morphine for pain (often referred to as MONA).

How do I know if I have anterior or posterior MI?

The ECG findings of an acute posterior wall MI include the following: ST segment depression (not elevation) in the septal and anterior precordial leads (V1-V4). This occurs because these ECG leads will see the MI backwards; the leads are placed anteriorly, but the myocardial injury is posterior.

Why is nitro bad for right sided MI?

What does a right sided ECG look for?

Right-Sided and posterior ECGs may be useful in identifying STEMI of the right ventricle and/or posterior wall.

When do you use right-sided ECG?

All patients with inferior wall myocardial infarction should have a right-sided ECG. ST-segment elevation in lead V4 R is the single most powerful predictor of right ventricular involvement, identifying a high-risk subset of patients in the setting of inferior wall myocardial infarction.

What does a right-sided ECG lead mean?

Atrial fibrillation in the context of myocardial infarction portends a poor prognosis and is driven by bradycardia, autonomic dysfunction, ischemia, myocyte inflammation, increased atrial pressures, and atrial dilation. 3 Third, such marked ST-segment elevations apparent in each right-sided ECG lead are unusual.

How does posterior wall myocardial infarction ( MI ) ECG review?

Posterior Wall Myocardial Infarction (MI) ECG Review. ST segment depression (not elevation) in the septal and anterior precordial leads (V1-V4). This occurs because these ECG leads will see the MI backwards; the leads are placed anteriorly, but the myocardial injury is posterior. A R/S wave ratio greater than 1 in leads V1…

Where does the posterior ECG lead go on the ECG?

Posterior ECG leads (V7-V9) are applied by moving V4-V6 to under the left scapula. Purpose: To detect posterior infarcts, which are often associated with inferior or lateral wall AMI

What causes ST segment depression in posterior ECG?

ST segment depression (not elevation) in the septal and anterior precordial leads (V1-V4). This occurs because these ECG leads will see the MI backwards; the leads are placed anteriorly, but the myocardial injury is posterior. A R/S wave ratio greater than 1 in leads V1 or V2. ST elevation in the posterior leads of a posterior ECG (leads V7-V9).