Which of the following statements BEST describes the finding that supports diagnosing right ventricular myocardial infarction in the setting of inferior STEMI?
- A ST elevation in lead V1 with reciprocal changes in V5–V6
- B Tall R wave in V1 with ST depression
- C ST elevation ≥1 mm in lead V4R ✓
- D Sinus tachycardia with right bundle branch block
Correct answer: C. ST elevation ≥1 mm in lead V4R
Explanation
ST elevation ≥1 mm in right-sided precordial lead V4R is the most sensitive and specific ECG finding for RV myocardial infarction complicating inferior STEMI. The triad of hypotension, elevated JVP, and clear lung fields in inferior STEMI should prompt right-sided ECG leads. RV MI has important management implications — nitrates and diuretics are avoided as preload reduction is detrimental.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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