Which coronary vessel is primarily responsible for myocardial infarction in a patient displaying ST elevation in V1, V2, and V3?

ST elevation in leads V1, V2, and V3 typically indicates a localized injury pattern that is characteristic of an anterior wall myocardial infarction. The primary coronary vessel supplying the anterior portion of the heart, including the interventricular septum and anterior wall of the left ventricle, is the left anterior descending artery (LAD).

When there is a blockage in the LAD, it results in compromised blood flow to these regions, leading to ischemia and subsequent infarction, which is reflected as ST segment elevation in the specified leads on an electrocardiogram (ECG). This finding is critical in the assessment of patients presenting with chest pain and suspected acute coronary syndrome, as timely intervention is necessary to restore blood flow and minimize myocardial injury.

In terms of the other vessels, the left circumflex artery primarily supplies the lateral wall of the left ventricle, while the posterior descending branch of the right coronary artery typically supplies the inferior wall. The right coronary artery can also supply parts of the inferior wall depending on individual coronary anatomy, particularly in right-dominant coronary systems. Neither of these would result in the ST elevation seen in V1, V2, and V3, which is directly linked to the LAD's territory.