Which lead finding is most indicative of a right ventricular infarction?

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Multiple Choice

Which lead finding is most indicative of a right ventricular infarction?

Right ventricular infarction shows up best in a right-sided chest lead, specifically V4R. This lead is placed on the right side to directly monitor the right ventricle, so ST elevation here indicates RV injury, especially when it occurs with an inferior MI from RCA occlusion. Leads V5, V2, and V3 reflect left ventricular territories (lateral, anterior) and don’t specifically indicate RV involvement. ST depression in V3 isn’t characteristic of RV infarct. Therefore, ST elevation in V4R is the most telling sign of a right ventricular infarction.

Right ventricular infarction shows up best in a right-sided chest lead, specifically V4R. This lead is placed on the right side to directly monitor the right ventricle, so ST elevation here indicates RV injury, especially when it occurs with an inferior MI from RCA occlusion. Leads V5, V2, and V3 reflect left ventricular territories (lateral, anterior) and don’t specifically indicate RV involvement. ST depression in V3 isn’t characteristic of RV infarct. Therefore, ST elevation in V4R is the most telling sign of a right ventricular infarction.

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