- HPI: 61M w/ epigastric pain followed by syncope
- Key ECG: ST elevation in V1 and V2, with ST depression and T-wave inversion in V5, V6 should always make you think of LVH with chronic ST-T abnormalities, even if the voltage does not meet LVH criteria. STE in V1 and V2, with ST depression in V5 and V6 is a pattern that occurs in Septal OMI, but it looks different that this and does not have the deep lateral T-wave inversion (Typical subtle ECG of LAD occlusion, in which ST depression in V5, V6 make it far MORE likely to be OMI (whereas with deep T-wave inversion, it makes it less likely, and more likely to be LVH – see this example). The inferior ST depression is still worrisome for possible high lateral OMI however all troponins were undetectable
- Link to full case @ Dr. Smith’s ECG Blog: 2020-02-06
