To monitor the right heart, which chest leads should be observed?

Monitoring the right heart, particularly the right atrium and right ventricle, is best achieved through the leads placed in the precordial region that are closest to these structures. The leads V1 and V2 are positioned over the right side of the heart and provide valuable electrical information about the electrical activity in the right atrium, right ventricle, and also can indicate the presence of right ventricular hypertrophy or strain.

V1 is located in the 4th intercostal space at the right sternal border, and V2 is in the same intercostal space at the left sternal border. Together, these leads give a detailed view of the electrical impulses as they travel through the right heart structures. This is essential for diagnosing conditions like right-sided heart failure or pulmonary issues, as well as assessing wall motion abnormalities during an electrocardiogram (ECG).

In comparison, the other leads mentioned provide limited or no direct information regarding the right heart. For example, leads V5 and V6 are located more laterally and focus on the left heart, while V3 and V4 predominantly assess the left ventricle. Thus, V1 and V2 are the optimal choices for evaluating the right heart's function.