Posterior wall MI not present

(A) ST elevation in V1-V3 leads# As the posterior myocardium is not directly visualised by the standard 12-lead ECG, reciprocal changes of STEMI are souht in the anteroseptal leads V1-3.> Posterior Mi is suggested by the following changes in V1-3: Horizontal ST depression Tall, broad R waves (>30ms) Upright T waves Dominant R wave (R/S ratio > 1) in V2.> In patients presenting with ischaemic symptoms, horizontal ST depression in the anteroseptal leads (V1-3) should raise the suspicion of posterior Ml. Typical appearance of posterior infarction in V2.