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Indicative vs Reciprocal - Ischemia Injury Infarction

Views of the heart

Views seen on a 12-Lead EKG that look directly at a surface of the heart are referred to as “indicative leads” i.e. the views provided on a standard (left side of the chest) ECG like II, III, aVF – inferior etc.

If additional views are required to view the right ventricle or posterior of the heart directly, the chest leads would actually have to be physically moved to either the right side or posterior wall of the chest.

This is not always practical or prudent in the emergency setting…so, many providers initially rely upon indirect (reciprocal) views.


Views of the heart that or indirect are often referred to as “mirror-image” or “reverse” or “reciprocal” views.

In this instance morphologic changes that we would typically expect to see would be the reverse or opposite change. Meaning, what we would expect to see elevated would be depressed and changes reflected in depression would be elevated.

What is up would be down and down would be up!

Authors and Sources

Authors and Reviewers


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