ST elevations in leads II, III, and aVF with reciprocal ST depression in aVL indicate involvement of which territory?

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Multiple Choice

ST elevations in leads II, III, and aVF with reciprocal ST depression in aVL indicate involvement of which territory?

Inferior STEMI. ST elevations in the inferior leads (II, III, and aVF) point to ischemia of the inferior wall of the left ventricle, which is typically supplied by the right coronary artery. The reciprocal ST depression in aVL occurs because that lead views the high lateral region opposite the inferior wall, so it shows the opposite deflection when the inferior wall is injured. This combination is classic for an inferior infarction, usually due to RCA occlusion. The other territories would produce different patterns—anterior in V1–V4, lateral in I, aVL, V5–V6, or posterior inferred from reciprocal changes in the anterior leads.

Inferior STEMI. ST elevations in the inferior leads (II, III, and aVF) point to ischemia of the inferior wall of the left ventricle, which is typically supplied by the right coronary artery. The reciprocal ST depression in aVL occurs because that lead views the high lateral region opposite the inferior wall, so it shows the opposite deflection when the inferior wall is injured. This combination is classic for an inferior infarction, usually due to RCA occlusion. The other territories would produce different patterns—anterior in V1–V4, lateral in I, aVL, V5–V6, or posterior inferred from reciprocal changes in the anterior leads.

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