ECG Changes in a Case of Posterior Myocardial Infarction in the Presence of Right Bundle Branch Block

A 70-year-old male with hypertension and diabetes presented to the emergency department with a 1-hour history of chest pain. Initial 12-lead ECG revealed a right bundle branch block (RBBB) and ST depression (STD) in V2-V4. The anterior STD prompted a 15-lead ECG in which there was no evidence of ST elevation (STE). With a positive troponin, cardiology was consulted and the patient was admitted as a high-risk non-ST-elevation myocardial …