Today’s educational topic: Posterior Wall MI
Posterior Wall MI tends to be the most overlooked, under-recognized 12 lead interpretation in the pre-hospital setting. Despite the approximate 20% overall incidence of all STEMIs, a posterior wall MI can be associated with significant morbidity. A Posterior STEMI usually involves the Posterior Descending Artery (PDA) which is USUALLY a branch off the RCA, hence why there is usually some kind of inferior involvement.
How do we know when and how to complete a posterior ECG? I have attached a useful chart that lists some indicators (to include ST depression in V1-V3) and how to complete a posterior 12 lead.
Also, visit this site for more information:
www.ncbi.nlm.nih.gov/books/NBK553168/
Take some time on your next shift to review this material and even practice applying a posterior 12 lead. I challenge all ALS providers to be the first to field diagnose a posterior wall MI after this email! You might get a free meal courtesy of the QA office.
Posterior Wall MI tends to be the most overlooked, under-recognized 12 lead interpretation in the pre-hospital setting. Despite the approximate 20% overall incidence of all STEMIs, a posterior wall MI can be associated with significant morbidity. A Posterior STEMI usually involves the Posterior Descending Artery (PDA) which is USUALLY a branch off the RCA, hence why there is usually some kind of inferior involvement.
How do we know when and how to complete a posterior ECG? I have attached a useful chart that lists some indicators (to include ST depression in V1-V3) and how to complete a posterior 12 lead.
Also, visit this site for more information:
www.ncbi.nlm.nih.gov/books/NBK553168/
Take some time on your next shift to review this material and even practice applying a posterior 12 lead. I challenge all ALS providers to be the first to field diagnose a posterior wall MI after this email! You might get a free meal courtesy of the QA office.
Melanie Higgins, BS, NRP Captain – EMS Quality Assurance Division of Emergency Services 16232 Elliott Parkway Williamsport, MD 21795 (cell) 301-491-2454 (office) 240-313-4376 (fax) 240-313-4375
R-side-and-posterior-ECG-guide.pdf