Which finding represents reciprocal changes in an inferior MI?

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Multiple Choice

Which finding represents reciprocal changes in an inferior MI?

Reciprocal changes are opposite-side ST shifts produced by the same infarct-related vector. In an inferior MI, the injured wall is the inferior wall, so you see ST elevation in the inferior leads (II, III, aVF). The opposite, or reciprocal, changes appear in the leads that “look” at the opposite side of the heart—namely the high-lateral leads I and aVL show ST-segment depression. That depression in I and aVL reflects the opposing current of injury from the inferior infarct. ST elevation in aVR is not the reciprocal pattern for an inferior MI; it can appear with diffuse ischemia or left main/proximal involvement and isn’t the classic opposite-lead change. ST elevation in lead II indicates the infarct-related area (the inferior wall) rather than a reciprocal change. Q waves in V1 point to a different region (often septal/anterior) or a prior infarct, not the reciprocal phenomenon.

Reciprocal changes are opposite-side ST shifts produced by the same infarct-related vector. In an inferior MI, the injured wall is the inferior wall, so you see ST elevation in the inferior leads (II, III, aVF). The opposite, or reciprocal, changes appear in the leads that “look” at the opposite side of the heart—namely the high-lateral leads I and aVL show ST-segment depression. That depression in I and aVL reflects the opposing current of injury from the inferior infarct.

ST elevation in aVR is not the reciprocal pattern for an inferior MI; it can appear with diffuse ischemia or left main/proximal involvement and isn’t the classic opposite-lead change. ST elevation in lead II indicates the infarct-related area (the inferior wall) rather than a reciprocal change. Q waves in V1 point to a different region (often septal/anterior) or a prior infarct, not the reciprocal phenomenon.

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