Teng Changqing, Department of Geriatric Cardiovascular Medicine, Nanjing Chest Hospital: Right ventricular infarction is often complicated by acute posterior wall myocardial infarction due to right coronary artery occlusion. In addition to the specific evolution of the right thoracic leads (V1, V3R, v6-v9) of the ECG (e.g., ST-segment decrease in V1-v3 and ST-segment elevation in v6-v9 in the posterior wall leads), the changes in leads 2, 3 and avF, which reflect the electrical activity of different parts of the inferior wall, are also different from those of simple acute inferior and posterior wall myocardial infarction. There is a difference. When symptoms are severe, severe retrosternal pain (or none) is present for hours to days, and nitroglycerin is ineffective. There is myocardial necrosis, abnormal elevation of serum enzymes, and typical electrocardiographic changes, often complicated by arrhythmias: enlarged heart, heart failure, and arrhythmias, caused by fibrosis of the myocardium due to prolonged myocardial ischemia, formerly known as “myocardial sclerosis”. The crux of the problem is that a wide variety of manifestations with atypical symptoms add to the diagnostic difficulties, such as angina pectoris in the elderly, manifested as shortness of breath or chest tightness, toothache, neck pain, epigastric pain, or transient ischemic attack. Myocardial infarction in the elderly is more painless, often with left heart failure, shock, arrhythmia or cerebrovascular ischemia as the first symptoms, manifested as confusion, fainting, mental abnormalities, nausea and vomiting, etc. The patient you mentioned may be an elderly person, right? When acute inferior and posterior wall myocardial infarction with right ventricular infarction was found at autopsy abroad, women underwent reperfusion therapy, non-invasive examinations and coronary angiography less frequently than men. There were significant differences in the occurrence of disease by age and sex. Women are much less likely than men to have non-invasive examinations and coronary angiograms in conditions greater than or equal to 75 years of age. Please treat at a local major hospital cardiac center is preferred. v1-v3 ST segment drop, if tracing posterior wall leads v6-v9 ST segment elevation is seen sufficiently developed (1 week)