Platinum Emergency Medical Technician - Paramedic (EMTP) 3.3 Practice Test

Know when to perform a right sided 12 lead (V4R)

For a suspected inferior MI For a suspected anterior MI When you suspect inferior MI to check right-sided involvement In all MI evaluations

Correct Answer:

When you suspect inferior MI to check right-sided involvement

Explanation:

Right-sided leads (V4R) are used specifically to check the right ventricle for involvement when an inferior myocardial infarction is suspected. Inferior MIs, often from occlusion of the right coronary artery, can extend to the right ventricle. If V4R shows ST-segment elevations, that confirms right ventricular infarction, which changes how you manage the patient (for example, you’d be more cautious with preload-reducing meds like nitrates and may prioritize fluids). This is why the test target is to perform a right-sided ECG when you suspect an inferior MI to assess right-sided involvement. It isn’t routinely needed for anterior MIs, and it isn’t necessary in every MI evaluation—only when inferior MI with potential RV involvement is suspected.

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