What indicates ST elevation in leads V2 and V3 but not in aVF?

ST elevation in leads V2 and V3 suggests the involvement of the anterior wall of the heart, which is primarily supplied by the left anterior descending (LAD) artery. In the context of the question, the pattern of ST elevation indicates that there may be a myocardial injury, specifically affecting the septal region.

ST elevation in V2 and V3 can signify a septal myocardial infarction, particularly when it occurs without accompanying ST elevation in lead aVF, which would usually indicate inferior wall involvement. The absence of elevation in aVF supports the idea that the issue is localized to the anterior aspect rather than the inferior wall.

To summarize, the presence of ST elevation in just V2 and V3 aligns with septal involvement, confirming the interpretation that supports the diagnosis of a septal myocardial infarction.