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Posterior (inferobasal) left ventricular wall

Territory

The basal part of the inferior wall facing backward; supplied by the circumflex posterolateral and obtuse marginal branches in most people, or by RCA posterolateral branches in right dominance. No standard lead faces it, so it shows as a mirror image in V1 to V3.

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

Detail

Supplied by
Circumflex (obtuse marginal and posterolateral branches) or RCA posterolateral branches
Leads
Mirror image in V1 to V3; directly in V7 to V9

When it goes wrong

Posterior MI

Horizontal ST depression in V1 to V3 with tall broad R waves and upright T waves, the mirror of a STEMI; confirmed by ST elevation in V7 to V9 and treated as a STEMI

Practise this structure

1 question in the bank tagged Myocardial Oxygen Supply.

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