What ECG sign most strongly suggests a right ventricular infarction?

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Multiple Choice

What ECG sign most strongly suggests a right ventricular infarction?

The strongest indicator of a right ventricular infarction on ECG is ST-segment elevation in the right-sided precordial lead V4R. This lead directly views the right ventricle, so when the RV is injured, the injury currents produce a focused ST elevation there. This finding is more specific for RV involvement than changes seen in standard left-sided leads. Other options don’t pinpoint the right ventricle. Delta waves in V4 point to Wolff-Parkinson-White syndrome, not infarction. A prolonged QT interval is a non-specific finding that can appear in many conditions. ST depression in inferior leads can reflect other ischemic patterns or reciprocal changes but does not specifically indicate a right ventricular infarction. So, ST elevation in the right-sided V4R lead best identifies RV infarction and has important implications for management.

The strongest indicator of a right ventricular infarction on ECG is ST-segment elevation in the right-sided precordial lead V4R. This lead directly views the right ventricle, so when the RV is injured, the injury currents produce a focused ST elevation there. This finding is more specific for RV involvement than changes seen in standard left-sided leads.

Other options don’t pinpoint the right ventricle. Delta waves in V4 point to Wolff-Parkinson-White syndrome, not infarction. A prolonged QT interval is a non-specific finding that can appear in many conditions. ST depression in inferior leads can reflect other ischemic patterns or reciprocal changes but does not specifically indicate a right ventricular infarction.

So, ST elevation in the right-sided V4R lead best identifies RV infarction and has important implications for management.

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