Comments about the electrocardiographic signs of right ventricular infarction.

This manuscript was written in an effort to emphasize the points made by Porter et al. (Clin Cardiol 1997; 20:971-973). Right ventricular infarction may be erroneously interpreted as an anteroseptal infarction because of elevation of the S-T segments in leads V1-V4. The two can be separated when, using the Grant method of analysis, the S-T segments are represented as vectors: the mean S-T vector is directed inferiorly, to the right, and anteriorly when there is an inferior-right ventricular infarct, and superiorly, to the left, and anteriorly when there is an anteroseptal infarction. Other aspects of right ventricular infarction are also discussed.