⚠️ Note:
- In cases of limited inferior wall injury, the ST vector of inferior MI localizes the area of infarction and is typically directed inferiorly and rightwards (yellow arrow)
- The ST vector of subendocardial ischaemia does not localize to the ischaemia and regardless of involved coronary region directs to lead aVR (blue arrow)
- The resultant average ST vector directs rightwards, causing ST elevation only in lead III and aVR (red arrow)
🚨 Aslanger pattern:
The following pattern may indicated a limited inferior OMI with multivessel disease in the right clinical context:
- STE only in lead III
- ST segment in V1 > V2
- ST-depression (STD) in V4-V6, with a positive/terminally positive T-wave