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When right ventricular involvement is suspected during an inferior wall myocardial infarction (MI), a right-sided EKG is performed. This specialized form of electrocardiography is essential because standard 12-lead EKGs may not adequately visualize the right ventricular leads and could miss ST-segment elevations indicative of right ventricular ischemia.

Inferior wall MIs, which primarily affect the posterior descending artery, can sometimes extend to include the right coronary artery territory, leading to potential right ventricular damage. The right-sided EKG places additional leads on the right side of the chest to enhance visibility of the right ventricular activity. This can help in identifying significant changes, such as ST elevation in the right precordial leads (V3R, V4R), which can suggest right ventricular MI, thereby guiding immediate management and treatment.