MI Localization ECG Mnemonic | USMLE Step 2 Cardiology High-Yield Review

Added: 2026-05-19

[00:00:00]And my localization freaking you out?

[00:00:01]Don't memorize, visualize. It's bigly, littlely, ass up, all down. And yes, it works. Bigly equals inferior MI leads two, three, and AVF. Classic right coronary artery territory. Looks like a boot on the ECG and kicks the AV node while it's down. Littlely equals high lateral MI leads one and AVL. High and left, just like the patient's blood pressure. If you miss it, ass up equals anteroseptal ST elevations. V1 and V2 equals septal. V3 and V4 equals anterior. All down equals lateral MI. V5 and V6, sometimes with one and AVL. Low lateral, either left anterior descending or left circumflex, depending on who's being lazy. Bigly, littlely, ass up, all down. It's fast, dirty, and board tested.