Answer MI 4

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Where is this myocardial infarction located?

ECG MI 4

Answer

Culprit lesion: RCA

1. sinus bradycardia
2. about 55/min
3. normal conduction
4. intermediate (normal) axis
5. normal p wave morphology
6. tall R in V2, otherwise normal QRS morphology
7. ST elevation in II, III, AVF (in III > II). Depression in I, AVL, V2.

• Conclusion: Inferoposterior MI caused by a RCA occlusion

Arguments in favor of RCA occlusion (instead of RCX):

• ST depression in I, AVL
• bradycardia
• ST elevation in III > II ('the highest ST elevation points at the culprit lesion')