ACS anatomical correlation

Ischemic Changes	Location	Coronary Artery
STE V1-V3, TWI Q waves in V1-V3 over time	Septal	Septal branch
STE V2-V4	Anterior	LAD
STE I, aVL, V5, V6 STD inf leads	Lateral	Circumflex
STE I, aVL, V2-6	Anterolateral	LAD + circumflex = Left main or 2 critical lesions
STE II, III, aVF STD in aVL (most common lead to see reciprocal change)	Inferior	RCA
STE V1 (only lead looking at RV) STE III > II (III more R facing) STE V1 > V2, STE V1 + STD V2	Right ventricle	RCA
STD in V1, V2, V3; R>S in V1 Tall R waves in V1-V3 (Q waves on back of heart) w/ upright TWs	Posterior aka Inferolateral	RCA (90%), LCA (10%)
STE avR>V1 Doesn't apply in SVT	Anterolateral	Left Main

See Also