UMEM Educational Pearls

Category: Cardiology

Title: anteroseptal ischemia vs. posterior STEMI

Keywords: acute MI, MI, myocardial infarction, acute coronary syndrome, posterior stemi (PubMed Search)

Posted: 10/9/2011 by Amal Mattu, MD (Updated: 1/18/2022)
Click here to contact Amal Mattu, MD

ST depression in the right precordial leads can be anteroseptal ischemia, but it can also be a posterior STEMI. What are the clues to posterior STEMI?

  • tall R waves in these leads is highly suggestive of posterior STEMI
  • upright T-waves in these leads is also suggestive of posterior STEMI

Posterior leads (a couple of leads placed in the left mid-back area below the tip of the scapula) can help confirm posterior STEMI if there's STE in those leads. If there's no STE, call it just ischemia!