- HPI: 60M with chest pain x 1 hr
- Cath: 100% (TIMI-0) thrombotic occlusion of the mid LAD, stented
- Key ECG: The ECG is a classic, pathognomonic ECG for acute LAD OMI. There is STE in V1 and de Winter morphology (hyperacute T wave with depressed ST takeoff / ST depression) in V2-V4. In the lateral leads V5-V6 and I and aVL there is STD that is likely in part reciprocal to the STE in V1. Also reciprocal STD in II and aVF, or potentially also de Winter morphology in inferior leads as well. With hyperacute T wave and STE in V1 and STD in V5-6, this constitutes an LAD OMI pattern that Dr. Smith is currently studying
- Link to full case @ Dr. Smith’s ECG Blog: