Recognition
- • Inferior MI (II, III, aVF ST↑)
- • ST ↑ III > II
- • V1 ST elevation
- • V4R ST ↑ ≥1 mm confirms RV involvement
Key findings
- • Occurs in 40% inferior MI (RCA proximal)
- • Preload dependent — nitrates cause profound hypotension
Clinical importance
- • Bradyarrhythmia + hypotension common
- • Higher in-hospital mortality
Management pearls
- • Avoid nitrates/morphine/diuretics
- • IV fluid bolus 500 mL crystalloid (up to 1–2 L)
- • Inotrope (dobutamine) if fluid non-responder
- • PPCI + right-sided leads on all inferior MIs
