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Answer for December 14, 2012


The EKG shows an acute inferior AND posterior infarction (note tall R wave in V2 with ST depression indicating a posterior Qwave and ST elevation!) Importantly, this infarction also involves the right ventricle (ST elevation in right-sided chest leads). Right sided infarctions often require fluids if hypotension is present (need to 'prime the pump'), in contrast to left ventricular infarction in which fluid administration may result in pulmonary edema (so hypotension/shock is treated with pressors and aortic balloon). Pearl: If you see an inferior infarction, check right-sided V leads by moving the V3 and V4 leads to the corresponding location on the right chest wall.



NOTE: EKG's are for internal educational purposes of the University of Massachusetts Department of Family Medicine. Please do not forward without permission from Dr. Golding!


  December 14 EKG