Answer MI 6

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Where is this myocardial infarction located?

ECG MI 6

Answer

Culprit lesion: RCA

1. sinusbradycardia
2. about 48/min
3. normal conduction
4. intermediate axis
5. normal p wave morphology
6. No pathologic Q or LVH
7. ST elevation in II and V5. ST depression in AVR, V2, V3. Also depression in III and AVF. Some elevation in I and AVL.

• Conclusion: Infero-lateral MI caused by an RCA occlusion.

Note! Usually RCA occlusions lead to ST elevation in leads III and AVF, which is not the case here. However, there is evident bradycardia which suggests RCA occlusion. V3 and V4 show slight ST elevation, but no more than 2 mm and therefore this elevation should not be considered significant.