So, I was responding to a post by RevMedic over at EMS Haiku (go there to see the actual strip) who was talking about a right-sided MI he might have caught through careful assessment and so on. I was talking about a tip that I got from a doc during a clinical on the medic unit, and realized Hey! This is one of those things I could put in my blog!
So here it is. Thinking logically, the lead V1 in a 12-lead EKG is the exact reciprocal of the lead placed on the back in a 15 of 18 lead (I don't know which one, since we haven't studied them, only talked about them briefly). Therefore, if you see a depression in V1, you should expect that there is reciprocal elevation in that lead on the back. Thinking further, the lead on the back is pretty much directly over the right ventricle, and therefore it makes sense to see elevation there.
So yeah. While it is not diagnostic by any means, seeing ST depression in V1 lead, when you don't see reciprocal elevation in any of the reciprocal leads, should lead you to suspect a right-sided MI, and move your leads over to double check.
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