MI Diagnosis in RBBB
As shown in the examples below, myocardial infarction diagnosis in right bundle branch block is not very different from normal MI diagnosis. As repolarisation in leads V1-V3 is often abnormal in RBBB, these leads cannot always be used for the diagnosis of ischemia.
Examples
Patient with RBBB and inferior MI. Notice left axis deviation.
Lead V4R in the same patient with RBBB and inferior MI clearly shows ST elevation.
The same patient before acut MI developed. Horizontal axis.
