Reversing lead IV

[jeremy83]

Confused with my cardiology - why do we reverse lead IV on a 12-lead? I must have blanked out during lecture because this part completely escaped me and I can't find it anywhere. THanks.

 

[truetiger]

If you're referring to V4 its to screen for RVI.

 

[chaz90]

If you're referring to V4 its to screen for RVI.

V4R. But yeah, if that's not what you mean, I have no idea what you're referencing.

 

[NomadicMedic]

A quick and easy explanation is here:

http://lifeinthefastlane.com/ecg-library/right-ventricular-infarction/

 

[the_negro_puppy]

Pt's with evidence of Inferior infarction should have V4R performed to confirm right ventricular involvement, which has higher mortality and can influence treatment such as the decision to use nitrates.

 

[46Young]

IIRC, 30% of inferior MI's (II,III, aVf) can have rt ventricular involvement. This is why the V4R is so important to record. If you have a rt ventricular MI, nitrates will reduce pre-load, and quickly drop the pt's BP. You'll want to withhold nitrates until you do a 12 and the V4R. In the event of cardiogenic shock, if you have evidence of a rt sided MI, you can infer that a fluid bolus may work better than a dopamine drip.