V2-V6, or if a significant Q is seen in lead L when at least 3 mm of R wave is present. Also highly suspicious are significant Qs in V2-V6. In the anterior leads, even a small Q should be considered significant when the Q is followed by an R wave and larger S wave. Normally, R waves become larger as the ECG moves from V1 to V4. ECG changes are seen in leads I and L, V5-V6.
Anterolateral infarction involves portions of the anterior and the lateral walls of the heart.
Lateral branches of the left anterior descending artery are at fault. ECG evidence of anterolateral infarction is seen in the more lateral anterior precordials, as well as the lateral leads. Leads I, L, and V4-V6 will be involved, with some degree of involvement of V3 and possibly V2. The inferior portion of the heart is supplied by the right coronary artery in most persons, but can also be serviced by the left circumflex artery, or by both. If the inferior portion of the heart is served by the left cirumflex artery, inferior infarction may be accompanied by lateral infarction, called inferolateral infarction.