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Inferior lead ST-segment Elevation (II, III, aVF) is with ST-segment elevation in V4R. V4R is achieved by removing V4 from the left side of the patient’s chest and placing the V4 lead on the patient’s RIGHT side of the chest at the 5th intercostal space at the midclavicular line.
Paramedics will identify ST-segment elevation in V4R and treatments may vary.
As a result of problems relating to right ventricular pump function and preload, nitrates may be withheld and the patient will be treated with IV fluids and analgesia pending an adequate blood pressure. | 
