- HPI: 40M with 1.5 hr chest pain
- Cath: 100% mid LAD occlusion after a large D1 3V formula score 22.6 (At a cutoff of 22.0, the sensitivity was 96% but with decreased specificity of 81%)
- Key ECG: Note there is not enough ST elevation to meet the standard criteria, which require at least 2 mm ST elevation at the J-point, relative to the PQ jct., in leads V2 and V3 for a male over 40 years old. In this case, there is 1 mm in V2 and 2 mm in V3. The T-waves looked too fat to be normal. Even though the 3V formula was not greater than 23.4, at 22.6, it was close enough to be worried.
- Link to full case @ Dr. Smith’s ECG Blog: 2014-11-22