Which lead placement is commonly used for monitoring inferior wall ischemia?

Monitoring inferior wall ischemia is primarily achieved through the placement of leads that focus on the inferior aspect of the heart, which receives blood primarily from the right coronary artery in a right-dominant coronary circulation. The three leads used for this purpose are leads II, III, and aVF.

Lead II captures electrical activity that moves from the right shoulder (where lead I is placed) down towards the left leg, which is particularly sensitive to changes in the inferior wall. Lead III provides additional information about the inferior wall by monitoring the electrical activity between the left arm and the left leg, while lead aVF views the heart from a vantage point above the feet, oriented towards the left leg as well. Together, these leads provide a comprehensive view of the inferior myocardial region, making them essential for identifying ischemic changes that may occur there.

The other lead combinations target different areas of the heart or specific issues not related to the inferior wall. For instance, leads I, aVL, and V5 focus more on the lateral and anterior walls of the heart, while leads V1, V2, and V3 are typically used to assess the anterior wall and the septal region. Leads aVR, aVL, and V6 also pertain to