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Medicine Acute coronary syndrome 5d6e962f

A 65-year old man presents with crushing chest pain for 2 hours. On examination, BP = 80/60 mm Hg and JVP are elevated 4 cm above the sternal angle. All are true about the condition shown except:

A
ST elevation in V4R
B
ST segment depression in lead II, III, aVF
C
Right ventricular infarction
D
Kussmaul sign +
High-Yield Explanation
The ECG shows * Sinus rhythm is present with a normal QRS axis and tall T waves. * ST elevation >1 mm in V4R and leads II, III, aVF * ST depression (reciprocal) is present in anterior leads. * Hence the diagnosis is right ventricular MI. * Right ventricular infarction leads to hypotension with clear lung fields and presence of elevated JVP (Kussmaul sign +).

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