Which combination of findings best indicates a posterior wall MI on ECG?

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Multiple Choice

Which combination of findings best indicates a posterior wall MI on ECG?

Posterior wall myocardial infarction often hides on a standard 12-lead ECG because the infarct current is directed toward the back of the heart. This creates reciprocal changes in the front leads: ST depression and a tall R wave in the anterior precordial leads, especially V1–V2. The opposite finding—ST elevations in posterior leads V7–V9—confirms posterior involvement. So the described pattern of ST depression and tall R waves in V1–V2 with reciprocal ST elevations in V7–V9 best indicates a posterior wall MI. In contrast, ST elevations in V1–V3 suggest an anterior/septal MI, ST elevations in II, III, aVF indicate an inferior MI, and ST elevations in I, aVL point to a high lateral MI.

Posterior wall myocardial infarction often hides on a standard 12-lead ECG because the infarct current is directed toward the back of the heart. This creates reciprocal changes in the front leads: ST depression and a tall R wave in the anterior precordial leads, especially V1–V2. The opposite finding—ST elevations in posterior leads V7–V9—confirms posterior involvement. So the described pattern of ST depression and tall R waves in V1–V2 with reciprocal ST elevations in V7–V9 best indicates a posterior wall MI. In contrast, ST elevations in V1–V3 suggest an anterior/septal MI, ST elevations in II, III, aVF indicate an inferior MI, and ST elevations in I, aVL point to a high lateral MI.

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