Isolated Right Ventricular Infarction ST elevation in V1-V3, V3R-V4R. Pattern or Tombstone or Giant R wave. It may confuse with anterior or anteroseptal MI. In isolated right ventricular infarction, the maximal change is usually in V1. Patient. 53 year old female was found unresponsive by her husband. Paramedic checked her blood sugar to be 20. Admitting ECG as above. Patient has history of end stage COPD, alcoholic abuse. The family requested no aggressive management. Echocardiogram was performed. The LV systoloc function was normal while the RV was dilated with akinetic wall motion.
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