- HPI: 60F with chest pain started 1 day PTA
- Cath: RCA culprit lesion with subtotal approximately “99%” lesion
- Key ECG: STE in leads II, III, and aVF, reaching at least 1.0 mm in III and aVF; Large Q wave in lead III; STD in aVL and I; Subtle STD in V2. Highly suggestive of inferoposterior transmural injury, with the most common etiology being Occlusion MI of the RCA until proven otherwise. The normal QRS complex followed by focal inferior STE and reciprocal STD in I and aVL is suggestive of inferior involvement, while the subtle STD maximal in V2 is highly suggestive of the posterior involvement.
- Link to full case @ Dr. Smith’s ECG Blog: 2021-04-30