Ecg: Anterior Infarct

| Finding | Location on ECG | Clinical Significance | | :--- | :--- | :--- | | | Leads V1–V4 (most specific) | Acute transmural ischemia (ongoing infarction) | | Reciprocal ST depression | Leads II, III, aVF (inferior leads) | Confirms acute injury (mirror image of anterior wall damage) | | Q waves (new or pathologic) | Leads V2–V4 | Transmural necrosis (irreversible damage) | | Loss of R wave progression | V1 to V4 (poor R wave height) | Old or evolving anterior infarct | | T wave inversion | Leads V2–V5 | Evolving ischemia (days to weeks after infarct) |