RV MI is important to recognize because its hemodynamic management is different. Consider it in any patient with ECG changes of inferior STEMI. Recording from right precordial leads is confirmatory, but strong clues of RV infarction are usually present on the standard 12 lead. Those I've used include ST elevation in V1 and lead III showing greater magnitude of ST elevation than the other inferior leads. This topic is reviewed in a recent post at Life in the FastLane which covers some other less well known clues.