Anterior leads V3 and V4

ECG leads / veins · V3 V4

Precordial leads facing the anterior wall and apex; ST elevation here means LAD occlusion, with reciprocal depression in the inferior leads.

Traced from the start

  1. Left (posterior) aortic sinus and left main stem
  2. Left anterior descending (anterior interventricular) artery
  3. Diagonal branches of the LAD
  4. Anterior left ventricular wall and apex
  5. Anterior leads V3 and V4

Detail

Territory
Anterior LV wall and apex (LAD)
Reciprocal change
ST depression in II, III and aVF

When it goes wrong

ST elevation across V1 to V6 with I and aVL

Extensive anterior STEMI from a proximal LAD occlusion; highest risk of cardiogenic shock

Upsloping ST depression with tall symmetrical T waves in V1 to V6 (de Winter pattern)

A STEMI equivalent of acute LAD occlusion; activate the cath lab

Practise this structure

1 question in the bank tagged Coronary Circulation.