Please see the following examples of the Acute Posterior STEMI & Acute Right Ventricular STEMI
The 12-Lead cardiogram plus Lead V8 shown in Illustration 13 is from a 48 year old female with complaints of chest pain. A 12-Lead ECG of a year earlier was normal.
This is a STEMI (Inferior), as manifested by ST elevation concave down and hyperacute T-waves in the inferior leads plus ST depression of reciprocity. Since it is an Inferior STEMI this should sound an alarm to look for evidence of a Posterior STEMI also. The importance of this determination is obvious, since it places more cardiac tissue in jeopardy and increases the risk of a worse prognosis.
- You will note diffuse ST Depression, maximum in leads V1, V2, V3, V4
- Lead V8 demonstrates ST Elevation of 1 mm
- Note in Lead V2 R > S (early transition)
- Prominent upright terminal portion T-wave Leads V1, V2, V3, V4
- broad-based R-wave (≥ 0.03 sec) in Lead V2, V3
- note the absence of LVH and LBBB
∴ This is an acute Posterior STEMI also.
INTERPRETATION: Yes. This is an Acute STEMI (Inferoposterior)
Example Illustration Acute Posterior STEMI
Example Acute RV STEMI