ELECTROCARDIOGRAPHIC DIAGNOSIS OF INFARCTION OF THE RIGHT-VENTRICULARANTERIOR WALL

Fifty cases of acute myocardial infarction manifesting in anterior che st leads were studied, The site of infarction was determined by detail ed two-dimensional echocardiography. Isolated left ventricular anteros eptal infarction was found in 32 patients, infarction of the anterior wall of the left as well as the right ventricle in 12, and infarction localized to the right ventricular anterior wall in 6. ST-segment depr ession followed by deep symmetrical T wave inversion, increasing in de pth from lead V-1 to lead V-3 without loss of the R wave in these lead s, was highly sensitive and specific in detecting isolated right ventr icular anterior wall infarction. ST-segment elevation in right-sided c hest leads was not useful. Concomitant ST-Segment depression in inferi or leads was highly specific and sensitive in diagnosing infarction of the right ventricular anterior wall in the presence of left ventricul ar anterior infarction.