- HPI: 60M with CAD presenting with 1 hr substernal chest pain
- Cath: LAD occlusion was opened
- Key ECG: There are symmetric T-waves and poor R-wave progression. There is 1 mm of ST elevation at the J-point in leads V2 and V3. This formerly met “criteria” for thrombolytics in the ACC/AHA guidelines of 2004, though of course this amount of ST elevation is very nonspecific. It is nonspecific because normal variant ST elevation can be even much greater. However, normal variant ST elevation always has better R-wave progression and asymmetric T-waves which have a slow upstroke and a rapid downstroke.
- Link to full case @ Dr. Smith’s ECG blog: 2013-06-18