Standard MI Localization
| ECG Leads | MI Location | Affected Artery |
| V1–V2 | Septal | LAD (Proximal) |
| V3–V4 | Anterior | LAD (Distal) |
| V1–V4 | Anteroseptal | LAD |
| V5–V6, I, aVL | Lateral | LCX |
| V1–V6, I, aVL | Anterolateral | LAD or LCX |
| II, III, aVF | Inferior | RCA (85%) or LCX (15%) |
Special & High-Yield
| Condition | ECG Findings | Affected Artery | Clinical Pearl |
| Posterior MI | ST-dep V1–V3; Tall R V1–V2 | PDA (from RCA) | Use V7–V9 to see elevation |
| Right Ventricle | ST-elev V4R | RCA (Marginal) | No Nitrates (preload dependent) |
Mnemonics & Anatomy
• L-L-L: Leads I, aVL, V5, V6 = Lateral = LCX.
• Inferior: Leads II, III, aVF = Bottom = RCA.
• Zipper: V1–V4 down chest = Anterior = LAD.
• Reciprocal: Inf (II, III, aVF) ↔ Lat (I, aVL).
• LAD: Ant 2/3 septum, Ant LV.
• LCX: Lat/Post LV.
• RCA: RV, SA/AV nodes.