During an acute lateral myocardial infarction, which leads show changes?

In the case of an acute lateral myocardial infarction, the leads that are most indicative of changes are I, aVL, V5, and V6. These leads are positioned to monitor the left side of the heart, specifically the lateral wall of the left ventricle.

When there is an infarction in the lateral myocardium, typically due to occlusion in the left circumflex artery, these leads will show significant ST elevation or other changes indicating ischemia or infarction. The leads I and aVL cover the lateral wall in the high lateral aspect, while V5 and V6 capture changes in the mid to lower lateral wall.

In contrast, the other choices primarily reflect different areas of the heart, such as the anterior or inferior regions, which would not provide the appropriate evidence for a lateral myocardial infarction. Thus, the selection of leads I, aVL, V5, and V6 accurately reflects the area of the heart affected by a lateral myocardial infarction, making it the correct answer.