- HPI: 50M with acute chest pain x 1 hr
- Cath: total thrombotic occlusion of the mid-LAD was opened and stented
- Key ECG: There is sinus rhythm with normal QRS complex except slightly sluggish R wave progression (this is due to acute LAD OMI, diminishing the R wave voltage in its distribution). We see STE in V2-V4, and a hint of STE in II, III, and aVF. Hyperacute T waves are present in V2-V4, and II, III, and aVF. The T waves in V5 and V6 could also be increased in size and area compared to baseline, but no baseline was available. There is a small amount of reciprocal STD in aVL (reciprocal from lead III), as well as a reciprocally negative T wave which is inappropriate for that QRS. This is highly suggestive of acute transmural infarction of anterior, lateral, and apical LV areas.
- Link to full case @ Dr. Smith’s ECG Blog: 2022-02-12