MI Diagnosis in RBBB

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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.

    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.

    Lead V4R in the same patient with RBBB and inferior MI clearly shows ST elevation.

  • The same patient before acut MI developed. Horizontal axis.

    The same patient before acut MI developed. Horizontal axis.

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