DSAE STEMI Review, Mod 1: Examples of Posterior & Right Ventricular STEMI

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.

Is  this a STEMI?Illustration 13. 12-Lead ECG plus Lead V8 of 48 year old Female with Chest Pain.


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