Answer MI 23

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Previous ECG: MI 22 | Next ECG: This was the last MI case, return to Cases and Examples

Where is this myocardial infarction located?

ECG MI 23. Click on image for enlargement.


V3 is positioned at V4R.

  • Following the 7+2 steps:
    • Rhythm
      • The ECG shows a regular rhythm. Every P wave is followed by a QRS complex. P waves are positive in I and AVF. Normal sinus rhythm
    • Heart rate
      • 40 bpm
    • Conduction (PQ,QRS,QT)
      • PQ: 160ms QRS: 90ms QT: 420ms QTc: 360ms
    • Heartaxis
      • QRS positive in I and AVF: normal heart axis
    • P wave morphology
      • Normal P wave morphology
    • QRS morphology
      • Pathologic Q waves in III and AVF. QS in V1 and V2. No ST elevation in V3 (=V4R).
    • ST morphology
      • ST elevation in II, III, AVF and V5. ST depression in I, AVL.
    • Compare with the old ECG (not available, so skip this step)
    • Conclusion?

sinusbradycardia with inferior-lateral myocardial infarction.