Which right-sided lead placement is used to detect right ventricular involvement in an inferior MI?

Which right-sided lead placement is used to detect right ventricular involvement in an inferior MI?

• A. V1R
• B. V2R
• C. V3R
• D. V4R

Answer: (D)

Right ventricular involvement in an inferior MI is best detected with a right-sided chest lead placed at the mirror position of V4 on the right side (V4R). This lead projects the anterior surface of the right ventricle directly, so if the RCA infarct extends to the RV, you’ll see ST elevations in this lead. V4R is the most sensitive single right-sided lead for RV infarction, more than V1R, V2R, or V3R. When this lead shows ST elevation, it confirms RV involvement and guides management, such as avoiding nitrates and ensuring adequate preload with fluids.

Right ventricular involvement in an inferior MI is best detected with a right-sided chest lead placed at the mirror position of V4 on the right side (V4R). This lead projects the anterior surface of the right ventricle directly, so if the RCA infarct extends to the RV, you’ll see ST elevations in this lead. V4R is the most sensitive single right-sided lead for RV infarction, more than V1R, V2R, or V3R. When this lead shows ST elevation, it confirms RV involvement and guides management, such as avoiding nitrates and ensuring adequate preload with fluids.