Acute Anterior MI

An acute Anterior STEMI is caused by acute occlusion of the left anterior descending artery. It features signs of coronary occlusion (hyperacute T waves, ST elevation, Q formation) in the anteroseptal leads along with reciprocal changes in the inferior leads. There may also be ST elevation in the lateral leads (anteroseptal MI) or inferior leads (wraparound LAD).

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ECG Library (148)

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In the ECGquest archives, this ECG has been tagged with: - 12-Lead Incorrect Machine Interpretation Anterior ST elevation Hyperacute T waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Acute Chest pain in a 50-something, and a “Normal” ECG

This ECG is from a man in his 50s who presented with acute chest pain.

This ECG shows anterior ST elevation with hyperacute T waves. The cause was a 100% proximal LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Anterior ST elevation Lateral ST elevation Reciprocal ST depression Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
5 Cardiologists said this is not a STEMI. But was it an OMI?

This ECG is from a man in his 50s who presented with waxing and waning chest pain starting at rest.

This ECG shows ST elevation V1-5, I, II and aVL with reciprocal depression in III. The cause was an anterior MI.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Hyperacute T waves Lateral ST elevation Reciprocal ST depression Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
The ECG was correct. The angiogram was not.

This ECG is from a man in his 70s who presented with chest pain and nausea on a background of previous MI.

This ECG shows sinus rhythm with PVCs and subtle ST elevation in I, aVL and V2 and reciprocal ST depression in III and aVF. Angiogram was negative. The most likely cause was a brief LAD occlusion that spontaneously reperfused.

In the ECGquest archives, this ECG has been tagged with: - Abdominal pain 12-Lead Anterior ST elevation Reciprocal ST depression ST elevation in aVL Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
OMI Confirmed by POCUS Echo in a 50 year man

This ECG is from a man in his 50s who presented with intermittent epigastric burning pain for 4 days that had become constant that morning.

This ECG shows ST elevation in aVL, I and V2-4 with reciprocal ST depression inferiorly. POCUS showed severe hypokinesis of the anterior wall. The cause was a large anterior MI.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Syncope 12-Lead Anterior ST elevation Pathological Q waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
A man in his 40s with chest pain and syncope after cocaine use

This ECG is from a man in his 40s who presented with chest pain and syncope after cocaine use. He had pain at the time of this ECG.

This ECG shows ST elevation in V1-5 with Q waves anterior and inferior. Brugada-like morphology in V1. The cause was an anterior MI.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST elevation Hyperacute T waves Lateral ST elevation Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
A Text Message in the Middle of the night. Do you give thrombolytics?

This ECG is from a man in his 60s who presented with chest pain.

This ECG shows subtle ST elevation V3-6 with hyperacute T waves in V4. The cause was an acute anterior MI.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST depression Hyperacute T waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
A 40 year old man with chest pain since last night

This ECG is from a man in his 40s who presented with chest pain since the previous evening, associated with vomiting and diaphoresis. He had recently stopped smoking.

This ECG shows subtle disproportionately tall T waves in V2-V3 and ST depression in V3-6 with slight ST elevation in V1. The cause was a 100% proximal LAD thrombotic occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead De Winter T waves Hyperacute T waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Would you have given thrombolytics to this NSTEMI patient?

This ECG is from a middle aged male who presented with chest pain and dyspnoea.

This ECG shows hyperacute T waves V2-6 (de Winter in V4-6), I and aVL, due to acute anterolateral MI.

In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest Chest pain Dyspnoea 12-Lead Tombstone ST elevation Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Would you have given thrombolytics to this NSTEMI patient? Repeat post arrest and ROSC

This ECG is from a middle aged male who presented with chest pain and dyspnoea. This ECG was recorded after a witnessed VF arrest, tenecteplase and multiple shocks.

This ECG shows massive anterior ST elevation due to acute anterolateral MI.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Chest leads Hyperacute T waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Serial Evolving ECGs all diagnostic of LAD OMI, but never meet STEMI criteria

This ECG is from a man in his 60s who presented with chest pain

This ECG shows anterior hyperacute T waves due to a proximal LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Hyperacute T waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
A patient with chest pain that is resolving. Computer interprets ED ECG as completely Normal.

This ECG is from a man in his 60s who presented with resolving chest pain.

This ECG shows hyperacute T waves in V2-4. The cause was an 80% obstruction of the LAD with a large thrombus. An earlier ECG showed ST segment elevation.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Hyperacute T waves Acute Anterior MI Acute Inferior MI Dr Smith's ECG Blog CC BY-NC
The computer and the cardiologist called this a “Normal EKG”

This ECG is from a woman in her 40s who presented with 'heartburn' overnight and then worsening chest pain 1 hour prior to arrival.

This ECG shows subtle MI with inferior and anterior hyperacute T waves and some reciprocal ST depression in aVL. The cause was a complete occlusion of a wraparound LAD.

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