Cardiology: posterior MI ECG: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: posterior MI ECG

Sample item

A patient with chest pain has ST depression and tall R waves in V1 to V3 with an upright T wave. Which step best confirms the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Record posterior leads V7 to V9

ST depression with tall R waves in V1-V3 is the mirror image of posterior wall ST elevation. Posterior leads V7-V9 placed on the back show the ST elevation directly. Confirmation matters because it is treated as STEMI.

Option by option

  • A. Serum BNP

    BNP reflects wall stress, not infarct localisation.

  • B. Record posterior leads V7 to V9 (correct)

    Correct. V7-V9 show ST elevation over the posterior wall.

  • C. Repeat ECG with lead V1 moved higher

    Moving V1 higher does not image the posterior wall.

  • D. Stress treadmill test

    Stress testing is unsafe in an acute coronary syndrome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Record posterior leads V7 to V9. ST depression with tall R waves in V1-V3 is the mirror image of posterior wall ST elevation.

Why is "Serum BNP" not the answer?

BNP reflects wall stress, not infarct localisation.

Why is "Repeat ECG with lead V1 moved higher" not the answer?

Moving V1 higher does not image the posterior wall.

Why is "Stress treadmill test" not the answer?

Stress testing is unsafe in an acute coronary syndrome.

What concept does this question test?

It tests Cardiology: posterior MI ECG in General Medicine. Posterior leads V7-V9 placed on the back show the ST elevation directly. Confirmation matters because it is treated as STEMI.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: posterior MI ECG?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.