Answer MI 23

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Previous ECG: MI 22 | Next ECG: This was the last MI case, return to Cases and Examples

Where is this myocardial infarction located?

ECG MI 23. Click on image for enlargement.


Answer

V3 is positioned at V4R.

  • Following the 7+2 steps:
    • Rhythm
      • The ECG shows a regular rhythm. Every P wave is followed by a QRS complex. P waves are positive in I and AVF. Normal sinus rhythm
    • Heart rate
      • 40 bpm
    • Conduction (PQ,QRS,QT)
      • PQ: 160ms QRS: 90ms QT: 420ms QTc: 360ms
    • Heartaxis
      • QRS positive in I and AVF: normal heart axis
    • P wave morphology
      • Normal P wave morphology
    • QRS morphology
      • Pathologic Q waves in III and AVF. QS in V1 and V2. No ST elevation in V3 (=V4R).
    • ST morphology
      • ST elevation in II, III, AVF and V5. ST depression in I, AVL.
    • Compare with the old ECG (not available, so skip this step)
    • Conclusion?


sinusbradycardia with inferior-lateral myocardial infarction.