Ragavendra R. Baliga, M.D
Assistant Professor
Division of Cardiology
University Of Michigan

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Question 3 of 39:

On examination his heart rate is 90 beats per minute, blood pressure is 140/100 mm Hg, he has normal heart sounds and his lungs are clear to auscultation.

This EKG shows that this patient has an inferior wall myocardial infarction.

You clicked 'False'

Correct!

The initial abnormality during a transmural myocardial infarction is elevation of ST segment, often with a peaked appearance of the T wave. After the first few minutes of an infarction the T waves become tall, pointed and upright and there is ST elevation. Typically ECG changes are usually confined to the leads that 'face' the infarction. Therefore, an inferior wall myocardial infarction is diagnosed when ECG findings are seen in leads II, III and aVF. Lateral infarction produces changes in leads I, aVL and V5/6. Reciprocal changes (ST depression) may be seen in leads V1 and V2 in inferior wall MI. Because no leads are placed on the patients back overlying the posterior wall, the clinician relies on chest leads V1 and V2 which are directly opposite the posterior wall and these record the inverse of what leads on the back would record. Therefore, ST depression will be seen in these leads.