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Posterior myocardial infarction — RACP Written MCQ

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HardCardiologyPosterior myocardial infarctionRACP Written

A 67-year-old man presents to a Melbourne emergency department with 2 hours of crushing chest pain and diaphoresis. The ECG shows horizontal ST depression in V1 to V3 with tall R waves in V2. Troponin is elevated and his blood pressure is 104/68 mmHg. What is the most appropriate management?

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Correct answer: C — Urgent reperfusion pathway for posterior myocardial infarction

ST depression in V1 to V3 with tall anterior R waves is a posterior STEMI equivalent. He needs immediate reperfusion assessment rather than delayed functional testing.

Reference: National Heart Foundation of Australia; Therapeutic Guidelines: Cardiovascular