- HPI: Acute onset chest pain x 20 min
- Cath: 100% occlusion of the mid-LAD
- Key ECG: On this ECG there is ST elevation in lead V2, and it must be explained. Is it benign? If it were benign, then there should be excellent R-wave progression. There is not. In fact, the R-wave gets smaller from V2 to V3. Furthermore, the T-waves are much more symmetric than the T-waves of early repolarization. If you plug these numbers into the 3V formula you get a value of 25 (Any value greater than 23.4 is suggestive of LAD OMI. Less than 4% of LAD occlusion have a value < 22.0.)
- Link to full case @ Dr. Smith’s ECG Blog: 2014-12-12