Janice, age 70, arrives at the office this morning without an appointment. she appears quite anxious and pale and is complaining of an intermittent aching across her chest radiating into her jaw that started about an hour ago and woke her out of a sound sleep. she took an antacid and tylenol 1000 mg, but this did not . her b/p is 165/95 and her heart rate is 108 bpm. an ecg shows normal sinus rhythm with 2-mm st-segment elevation in leads ii, iii, and avf. what do you suspect?

In the given case, Janice is suspected to have an acute inferior wall myocardial infarction.

A 12-lead electrocardiogram demonstrating 2-mm ST-segment elevations in leads II, III and AVF suggests an acute inferior wall myocardial infarction. The inferior wall myocardial infarction takes place from a coronary artery occlusion with subsequently reduced perfusion to that region of the myocardium.

In the majority of the patients, the inferior myocardium is supplied by the right coronary artery. About 40 percent of all myocardial infarctions involve the inferior wall.

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