Posterior MI

Question 1

What is a posterior MI?

Answer 1

MI occurring in the posterior aspect of the heart.

Question 2

How do I recognise a posterior MI?

Answer 2

• Initial STD of >0.5mm in V1, V2 and V3
• Tall broad R waves (>30ms)
• Dominent R wave in V2
• Once the ECG dots have changed to the posterior side confirmation of STE >0.5mm in 2 or more consecutive leads (V7, V8, V9).

Question 3

what leads can a posterior MI be present in?

Answer 3

Once STD noted in V1-V3, leads V4-V6 need to be moved mirror opposite of the patients posterior side and renamed V7, V8, V9.

Question 4

Signs and symptoms of posterior MI

Answer 4

• Chest pain
• Nausea
• Shortness of breath
• Shock

Question 5

Significance of Posterior MI?

Answer 5

• 15-20% of all STEMI’S are classified as having posterior involvement, typically in association with inferior or lateral infarcts.
• Isolated posterior infarcts are less common 3-11%.