#case43 infero-posterior STEMI
• Subtle inferior STE and hyperacute T waves (T waves > QRS complexes)
• ST depression and terminal T-wave positivity in V2-3 = posterior wall involvement
How to diagnose posterior MI ?
Look specifically at leads V2-3 for the combination of:
• Horizontal ST depression.
• Tall, broad R wave (>30ms wide, R/S ratio > 1) . this is a Q-wave equivalent.
• Upright T wave ,particularly the terminal portion of the T wave.
Sometimes it can be difficult to determine whether ST depression in V2-3 is due to posterior STEMI or simply subendocardial ischaemia affecting the anteroseptal wall (reciprocal changes). The diagnosis can be confirmed by recording posterior leads V7-9.
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