posterior leads Archives - Dr. Smith’s ECG Blog

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3 Min Read

onJune 2, 2025

Should you record posterior leads? Should you give thrombolytics for chest pain with this ECG (if PCI not available)?

This was sent by Kirk Lufkin and was diagnosed by a Physician Assistant who works with him by the name of Danielle Hutcheson. They…

5 Min Read

Steve Smith

onSeptember 29, 2024

50 yo with V fib has ROSC, then these 2 successive ECGs: what is the infarct artery?

A 50 yo was resuscitated from ventricular fibrillation. He had a prehospital ECG recorded after ROSC: What do you think?…

10 Min Read

Jesse McLaren

onMay 27, 2024

Chest pain: Are these really “Nonspecific ST-T wave abnormalities”, as the cardiologist interpretation states?

Written by Jesse McLaren, with a very few edits by Smith A 60-year-old presented with chest pain. The ECG did not meet STEMI criteria,…

3 Min Read

Pendell Meyers

onMarch 31, 2024

What happened after the Cath lab was activated for a chest pain patient with this ECG?

Sent by anonymous, written by Pendell Meyers I received a text with this image and no other information: What do you think? I simply texted…

5 Min Read

Jesse McLaren

onFebruary 9, 2024

Chest pain with anterior ST depression: look what happens if you use posterior leads.

Don’t forget to watch the Webinar: Smith and Pendell Meyers interpret ECGs for OMI or not OMI on Monday Feb 12 at 11 AM U.S.…

8 Min Read

Emre Aslanger

onDecember 18, 2022

A young patient with diminishing pain with a subtle but diagnostic ECG.

Written by Emre Aslanger (Emre is our newest editor. He is an interventionalist in Turkey and one of 3 originators of the OMI/NOMI…

6 Min Read

Steve Smith

onSeptember 21, 2022

Posterior leads can give false reassurance

A 40-something woman with diabetes and peripheral vascular disease who frequently needs the ED for chronic pain called 911 for sudden severe…

8 Min Read

Jesse McLaren

onMay 3, 2022

Why is there inferior ST elevation, and would you get posterior leads?

Written by Jesse McLaren, with comments by Smith and Grauer A 75 year-old presented with 8 hours of epigastric pain and one episode of…

4 Min Read

Pendell Meyers

onDecember 27, 2021

Did the posterior leads help here? Why not just get good at STDmaxV1-V4?

Written by Pendell Meyers A middle aged woman presented with chest pain and dyspnea. Her exam and vitals were within normal…

4 Min Read

Steve Smith

onNovember 25, 2021

Any ST depression in V2 and V3 is posterior OMI until proven otherwise, especially if downsloping

A middle aged male presented after onset, approximately 50 minutes prior, of constant crushing 10/10 substernal chest pain, radiating into…

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Dr. Smith's ECG Blog

posterior leads

Should you record posterior leads? Should you give thrombolytics for chest pain with this ECG (if PCI not available)?

50 yo with V fib has ROSC, then these 2 successive ECGs: what is the infarct artery?

Chest pain: Are these really “Nonspecific ST-T wave abnormalities”, as the cardiologist interpretation states?

What happened after the Cath lab was activated for a chest pain patient with this ECG?

Chest pain with anterior ST depression: look what happens if you use posterior leads.

A young patient with diminishing pain with a subtle but diagnostic ECG.

Posterior leads can give false reassurance

Why is there inferior ST elevation, and would you get posterior leads?

Did the posterior leads help here? Why not just get good at STDmaxV1-V4?

Any ST depression in V2 and V3 is posterior OMI until proven otherwise, especially if downsloping