Answer MI 5

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Where is this myocardial infarction located?

ECG MI 5

Answer

Culprit lesion: RCX

1. sinus rhythm
2. about 60/min
3. normal conduction
4. intermediate axis
5. normal p wave morphology
6. No pathologic Q or LVH. Tall R in V2, V3.
7. ST depression in V2, V3. Also depression in III and AVF. Some elevation in I and AVL.

• Conclusion: Postero-lateral MI caused by an RCX occlusion.

Note! The high frequency vibration that is most clearly seen in lead AVR (with a frequency of > 300/min) is an artefact and not a suprvaventricular tachycardia. In SVT, there would be no P waves.

It is quite unusual that lead III shows depression in a RCX infarction. Apparently the inferior part is not much affected by this infarction.