BOF: 2.6
A 56-year-old male presented with crushing central chest
pain associated with nausea, vomiting and sweating. His ECG showed ST elevation
and T inversion in leads II, III and AVF. He is a known diabetic and has
proliferative retinopathy and in view of this thrombolysis was withheld. A few
hours later he develops a tachycardia, he becomes hypotensive, his JVP is
elevated. On auscultation heart sounds are soft with a fourth heart sound, lung
fields are clear. In this patient which of the following leads will show the
location to which the infarction has extended?
a)
Lead I
b)
AVL
c)
AVR
d)
V4 R
e)
V6
Answer:
d)
The patient presented with an inferior infarction. The
clinical features that are obtained when he becomes hypotensive suggest right
ventricular infarction
, which is indicated by ST segment elevation in the right-sided lead, V4R
Revision Tip
Revise myocardial infarction KEYS
to SUCCESS in Medicine page 143-148
