Abstract
The diagnostic accuracy of ST elevation in lead III exceeding that of lead II (ratio III II > 1 ) in the diagnosis of right ventricular infarction was investigated in 24 autopsied patients with inferior/posterior myocardial infarction on ECG. The results were compared with the diagnostic accuracy of ST elevation ≥1 mm in right-chest leads V 3R to V 7R recorded in the same patients. All had left ventricular infarction documented at autopsy, and 17 (71%) had concomitant right ventricular involvement. The highest specificity (100%) and positive predictive value (100%) were calculated for the right-chest leads, whereas values for ratio III II > 1 were 88% and 91%, respectively. The differences were not statistically significant. It is concluded that differences in ST elevation in leads III and II can be the basis for a diagnosis of right ventricular involvement in ECG-diagnosed inferior/posterior infarction. The diagnosis, however, may be achieved more easily with right-chest leads.
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