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Inferior leads II, III and aVF

ECG leads / veins · II III aVF

Limb leads looking up from the feet at the diaphragmatic surface; ST elevation here is inferior STEMI, RCA in 80% and circumflex in 18%.

Traced from the start

  1. Right (anterior) aortic sinus
  2. Left (posterior) aortic sinus and left main stem
  3. Right coronary arteryLeft circumflex artery
  4. Posterior descending (posterior interventricular) artery
  5. Inferior (diaphragmatic) left ventricular wall and posterior third of the septum
  6. Inferior leads II, III and aVF

Detail

Territory
Inferior wall (posterior descending artery)
Reciprocal change
ST depression in aVL, and often I
RCA versus circumflex
III greater than II with aVL depression favours RCA; II equal to or greater than III favours circumflex

When it goes wrong

Inferior STEMI with ST elevation in V1 (or V1 elevation with V2 depression)

Right ventricular involvement; confirm with V4R and avoid nitrates

Inferior STEMI with additional ST depression in V1 to V3

Posterior extension, a larger infarct; record V7 to V9

Practise this structure

1 question in the bank tagged Coronary Circulation.

A 62-year-old man describes tightness across the chest when he walks up the hill to his home; it settles within three minutes of rest. He first noticed it a mon…

Foundations · common