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Chest pain and shock: Is there a right ventricular OMI on this ECG? And should he undergo trancutaneous pacing?

Dr. Smith's ECG Blog

We recorded an ECG in which V1-V3 were put in the position of V4R-V6R, and V4-6 were placed in V7-9 to (academically) confirm posterior OMI. I say academically because the STD in V2 is diagnostic -- posterior leads are NOT necessary. Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Academic Emergency Medicine., Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. orthostatic vitals b.