Where do leads go on posterior ECG?

Posterior leads Leads V7-9 are placed on the posterior chest wall in the following positions: V7 – Left posterior axillary line, in the same horizontal plane as V6. V8 – Tip of the left scapula, in the same horizontal plane as V6. V9 – Left paraspinal region, in the same horizontal plane as V6.

Which ECG leads are posterior?

ST elevation in the posterior leads of a posterior ECG (leads V7-V9). Suspicion for a posterior MI must remain high, especially if inferior ST segment elevation is also present.

Where should V1 of the ECG chest leads be placed?

V1 is placed to the right of the sternal border, and V2 is placed at the left of the sternal border. Next, V4 should be placed before V3. V4 should be placed in the fifth intercostal space in the midclavicular line (as if drawing a line downwards from the centre of the patient’s clavicle).

How does a posterior MI appear on an ECG?

ECG findings: The ECG in posterior STEMI is first characterized by ST-depression in the anterior leads. The ST depression is often deep (>2mm) and flat (horizontal). There will be a large R-wave in V2-3, even bigger than the S-wave. Normal R-waves progressively increase in height across the precordial leads.

Why would you do a posterior ECG?

Clinical Significance of Posterior MI Posterior extension of an inferior or lateral infarct implies a much larger area of myocardial damage, with an increased risk of left ventricular dysfunction and death. Isolated posterior infarction is an indication for emergent coronary reperfusion.

Is posterior MI serious?

Complications. The risk of ventricular aneurysm, rupture and death may be greater than with myocardial infarctions at other sites. Rupture of chordae tendinae can lead to valve incompetence. Rupture of the septum appears to be a special risk with a high mortality despite surgical repair.

When is a posterior ECG used?

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).

How do you place a 3 lead ECG electrode?

Position the 3 leads on your patient’s chest as follows, taking care to avoid areas where muscle movement could interfere with transmission:

1. WHITE.
2. RA (right arm), just below the right clavicle.
3. BLACK.
4. LA (left arm), just below the left clavicle.
5. RED.
6. LL (left leg), on the lower chest, just above and left of the umbilicus.

How is posterior MI treated?

The definitive management of acute posterior STEMI is reperfusion therapy. Optimally this is done via percutaneous coronary intervention (PCI), though the next option would be fibrinolytic therapy. PCI is the preferred option if it can be initiated within 120 minutes, though within 90 minutes is the goal.

When would you do a posterior ECG?

What’s the proper placement of a 12 lead ECG?

Proper 12-Lead ECG Placement. Aside from a 12-lead ECG placement, there’s something known as a 15-lead placement which includes placing leads V4-V6 on the posterior side of the patient below their left scapula (see below). When viewing the EKG strip, V4-V6 on the strip will be referred to as V-13-15.

Where are the posterior leads placed in the electrocardiogram?

Posterior Leads Electrodes Placement for Posterior Leads Posterior leads are helpful in suspected posterior myocardial infarction. They are performed by placing V4, V5 and V6 electrodes in the same intercostal space, but continuing into the patient’s back.

What to look for in a posterior myocardium ECG?

As the posterior myocardium is not directly visualised by the standard 12-lead ECG, reciprocal changes of STEMI are sought in the anteroseptal leads V1-3. In patients presenting with ischaemic symptoms, horizontal ST depression in the anteroseptal leads (V1-3) should raise the suspicion of posterior MI.

What does an ECG look like for mitral stenosis?

In patients with moderate-to-severe mitral stenosis, the ECG can show signs of left atrial enlargement (P wave duration in lead II >0.12 seconds, P wave axis of +45 to -30 marked terminal negative component to the P wave in V 1 [1 mm wide and 1 mm deep]) and, commonly, atrial fibrillation.