🚨 Suggestive of OMI:
- Terminal QRS Distortion:
- Terminal QRS (TQRSD) distortion in V2 or V3 is a specific finding for LAD occlusion when trying to differentiate from early repolarization
- When the differential is LAD occlusion vs early repolarization, TQRSD was 100% specific for LAD occlusion in 171 cases
- TQRSD is defined by ABSENCE of BOTH S-wave (reaching below isoelectric/PR) and J-wave (elevation of J-point above ST segment) in V2 or V3
- Any STE or hyperacute T wave in inferior leads (especially lead III) associated with any STD in aVL
- Any STD depression in inferior leads with associated STE in aVL