Anterior ST elevation occurs in leads V3 and V4. It can be difficult to distinguish normal variant ST elevation in these leads from coronary occlusion.See also: ST segment
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This ECG is from a man in his 30s who presented with chest pain for a week on a background of anxiety, asthma and alcohol use disorder.
This ECG shows ST elevation in V2-6, with convexity. Serial ECGs showed no evolution and serial troponins did not rise. The 4-variable formula gives a false positive with this ECG due to the convexity.
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.
This ECG is from a man in his 50s who presented with less than an hour of chest pain. This was his initial ECG.
This ECG shows subtle ST elevation in V2 and V3 with a very small amount of ST depression in V4-6. He was monitored and the ECG progressed into a clear STEMI. Catheterisation showed 95% proximal LAD stenosis and occluded 1st diagonal.