Acute myocardial infarction: The Daily PANCE Blueprint

The answer is A. Leads I, aVL, V5, and V6

Anterolateral myocardial infarction involves the anterior and lateral walls of the left ventricle, typically affecting the distribution areas of the left anterior descending (LAD) and left circumflex (LCX) arteries. The leads that best visualize these areas are I, aVL (which view the lateral wall), and V5, V6 (which view the lateral and lower parts of the anterior wall). These leads will show characteristic changes such as ST elevation in the case of an acute MI.

Explanation for Incorrect Answers:

• B. Leads II, III, and aVF are primarily used to diagnose inferior myocardial infarctions, which typically involve the right coronary artery (RCA) or occasionally the LCX, but do not provide direct views of the anterolateral wall.
• C. Leads V1 and V2 view the septal region of the heart. While these can show changes in an extensive anterior wall MI, they are not the most specific for diagnosing anterolateral MI, as they do not adequately cover the lateral wall.
• D. Leads V3 and V4 are best for diagnosing anterior myocardial infarctions, particularly those involving the anterior descending branch of the left coronary artery. These leads look directly at the anterior wall but not the lateral wall of the heart, which is involved in anterolateral MI.
• E. Leads V1 through V4 together view the anterior and septal walls of the heart. Although they can show changes in extensive anterolateral infarctions, they are not as specific as the combination of leads I, aVL, V5, and V6 for diagnosing involvement of both the anterior and lateral walls.