A 64-year-old woman presents with severe substernal chest pain. ECG shows ST-segment depression in leads V1 to V3 with prominent R waves. Which additional leads should be recorded to confirm the diagnosis?
- A V7 to V9 ✓
- B V4R and V5R
- C High lateral leads I and aVL
- D Right-sided V1 to V3
Correct answer: A. V7 to V9
Explanation
ST depression in V1 to V3 with tall R waves is the mirror image of ST elevation seen in acute posterior MI. Recording posterior leads V7 to V9 is required to directly visualize the ST elevation. Right-sided leads confirm RV infarction, while I and aVL show high lateral changes.
Reference: Goldman-Cecil Medicine, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.