12 Lead Discussion
ST elevation is noted in leads II, III, and aVF. Reciprocal changes are seen in leads I and aVL. Note ST elevation extends into the lateral precordial leads of V4, V5, and V6. Also of significance is the ST segment depression in leads V2 and V3. Though the R waves aren't especially tall, the ST depression and slightly positive R waves is consistent with extension of the infarction into the heart's posterior wall. A large obstructing lesion of the right coronary artery can affect these geographic areas of the heart. Posterior wall MIs usually do not occur in isolation. The "Life in the Fast Lane" blog has a good page on the interpretation of the posterior wall myocardial infarction.
12 Lead Interpretation
Inferior lateral ST elevation myocardial infarction with extension into the posterior wall.
