title: Simultaneous ST-segment elevation in lead V1 and depression in lead V2. A discordant ECG pattern indicating right ventricular infarction.
abstract: The major electrocardiographic change in right ventricular infarction (RVI) is ST-segment elevation in leads V4R-V6R. The authors describe a discordant electrocardiographic pattern of ST-segment elevation in lead V1 and ST-segment depression in lead V2 in five patients presenting with acute transmural (Q wave) inferior infarction and RVI. There were 51 patients with transmural inferior infarction from a thrombolytic trial. In 25 patients, the ST-segment in the right-sided precordial leads was elevated by > or = 1 mm indicating the presence of RVI. In 5 of these 25 patients, simultaneous ST-segment elevation of 1.0-8.0 mm (mean, 2.8 +/- 2.9 mm) in lead V1 and ST-segment depression of 2.5 to 4.0 mm (mean, 3.3 +/- 0.6 mm) in lead V2 were also present. The discordant pattern of the ST-segments in leads V1 and V2 is an important and specific sign for RVI.
authors.affiliation: Department of Cardiology, Singapore General Hospital.
authors.forename: K H
authors.initials: KH
authors.lastname: Mak
authors.forename: B L
authors.initials: BL
authors.lastname: Chia
authors.forename: A T
authors.initials: AT
authors.lastname: Tan
authors.forename: A
authors.initials: A
authors.lastname: Johan
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D015635:Radionuclide Ventriculography; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016278:Ventricular Function, Right / Q000502:physiology*
chemical_list: D013300:Streptokinase; D010959:Tissue Plasminogen Activator