An acute Lateral MI features signs of coronary occlusion (hyperacute T waves, ST elevation, Q formation) in the lateral leads (V5, V6, I, aVL) along with reciprocal changes in III and aVF. There may also be anterior infarction or posterior infarction. The culprit can be LAD (anterolateral), left circumflex (inferior-posterior-lateral) or smaller branches (isolated lateral).See also: Basic STEMI localisation
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This ECG is from a man in his 40s who presented with intermittent left sided pleuritic chest pain for 3 days.
This ECG shows anterior ST elevation, but there was no anterior wall motion abnormality on echo - there was an inferolateral regional wall motion abnormality instead. Initial troponin was very high. He was found to have a 100% obtuse marginal occlusion. The ECG did not evolve over the next few days, suggesting that it was the patient's baseline ECG.