Localization of myocardial injury
The different leads monitor different anatomic regions of the heart.
Thus, the different leads are used to detect myocardial injury in their
corresponding regions of the heart. In an ECG tracing, myocardial injury
can be localized to the following anatomic regions of the heart:
Lateral wall: Left wall of the left ventricle. Leads I, aVL, V5, and V6 are used
Inferior wall: The part of the left ventricle resting on the diaphragm.
Leads II, III, and aVF are used
Anterior wall: Ventral (front) wall of the left ventricle. Leads V2, V3, V4,
and sometimes V1 and/or V5 are used
Posterior wall: The dorsal (back) part of the left ventricle. Leads V1, V2, V3,
and V4 are used to monitor the reciprocal changes
Septal region: The interventricular septum. Leads V1 and V2 are used
Right ventricle: Lead V4R is used. This lead is not part of the standard ECG
leads and is placed in a similar manner as lead V4 but on the right side of the
chest. Lead V4R is only placed if the patient is suspected of having a myocardial
infarction involving the right ventricle.
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