ST elevations in V1, V2 indicate which MI and artery?

ST elevations in V1, V2 indicate which MI and artery?

• A. Anteroseptal MI, left anterior descending artery
• B. Posterior wall MI, posterior descending artery
• C. Lateral wall MI, left circumflex artery
• D. Inferior MI, right coronary artery

Answer: (B)

ST elevations in the anterior chest leads V1 and V2 localize to the anterior interventricular septum, which is supplied mainly by the left anterior descending artery. When an anteroseptal myocardial infarction occurs, injury current is best seen in these septal leads early on, and may extend to neighboring anterior leads as the infarct evolves. Posterior wall infarction is suggested by ST depression in V1–V3 (with corresponding ST elevations in posterior leads such as V7–V9), and the artery supplying the posterior wall is typically the posterior descending artery in a dominant circulation, not the source you'd expect from isolated V1–V2 changes. Lateral wall infarction shows ST elevations in I, aVL, V5–V6 due to the left circumflex, while inferior infarction shows elevations in II, III, aVF from the right coronary artery. Therefore, ST elevations in V1–V2 best indicate an anteroseptal MI due to left anterior descending artery involvement.

ST elevations in the anterior chest leads V1 and V2 localize to the anterior interventricular septum, which is supplied mainly by the left anterior descending artery. When an anteroseptal myocardial infarction occurs, injury current is best seen in these septal leads early on, and may extend to neighboring anterior leads as the infarct evolves.

Posterior wall infarction is suggested by ST depression in V1–V3 (with corresponding ST elevations in posterior leads such as V7–V9), and the artery supplying the posterior wall is typically the posterior descending artery in a dominant circulation, not the source you'd expect from isolated V1–V2 changes. Lateral wall infarction shows ST elevations in I, aVL, V5–V6 due to the left circumflex, while inferior infarction shows elevations in II, III, aVF from the right coronary artery.

Therefore, ST elevations in V1–V2 best indicate an anteroseptal MI due to left anterior descending artery involvement.