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Posterior leads V7 to V9

ECG leads / veins · V7 V8 V9

Extra leads placed on the back at the level of V6 (V7 posterior axillary line, V8 tip of the scapula, V9 paraspinal) to look directly at the posterior wall; they are the only leads that show posterior infarction as ST elevation.

Traced from the start

  1. Left (posterior) aortic sinus and left main stem
  2. Left circumflex artery
  3. Right (anterior) aortic sinus
  4. Right coronary artery
  5. Obtuse marginal branches of the circumflexPosterior descending (posterior interventricular) artery
  6. Posterior (inferobasal) left ventricular wall
  7. Posterior leads V7 to V9

Detail

Territory
Posterior (inferobasal) wall, usually circumflex
STEMI threshold
ST elevation of 0.5 mm in any of V7 to V9 (1 mm in men under 40)

When it goes wrong

Chest pain with ST depression in V1 to V3 and a normal-looking 12-lead elsewhere

Record V7 to V9: 0.5 mm elevation confirms posterior STEMI and mandates reperfusion

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