ECG Quest > Shapes > ST segment > Anterior ST elevation

Anterior ST elevation

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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In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation Inferior ST elevation Lateral ST elevation Normal ST elevation Normal vs. abnormal anterior ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
A 60-something with syncope

This ECG is from a man in his 60s who had a witnessed sudden loss of consciousness and awakening.

This ECG shows widespread ST elevation without reciprocal ST depression. Angiography was normal.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation Hyperacute T waves Inferior ST depression Lateral ST depression Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
A man in his sixties with chest pain at midnight with undetectable troponin

This ECG is from a man in his 60s who presented with 3 hours of chest pain.

This ECG shows ST elevation and hyperacute T waves in V2 with inferior and lateral ST depression. The cause was acute LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Hyperacute T waves Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
A 50-something male with acute chest pain

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

This ECG shows anterior ST elevation and hyperacute T waves due to 100% LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Hyperacute T waves 12-Lead Dr Smith's ECG Blog CC BY-NC
What happens when you don’t recognize an OMI?

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

This ECG shows hyperacute T waves and anterior ST elevation that evolved to cardiogenic shock due to a left main occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Hyperacute T waves Late R wave transition Pathological Q waves Premature ventricular complex Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
What happens when a patient with LAD OMI does not go immediately to the cath lab?

This ECG is from an elderly woman who presented with chest pain.

This ECG shows ST elevation V2-4 with poor R progression and hyperacute T waves. The cause was an acute LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation J wave Lateral ST elevation Normal ST elevation Normal vs. abnormal anterior ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Three EKGs shown to me – which if any need emergent reperfusion?

This ECG is from a man in his 30s with unknown symptoms.

This ECG shows ST elevation (false positive) with clear J waves. Angiogram, troponins and serial ECGs were normal.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Straightened ST segment 12-Lead Dr Smith's ECG Blog CC BY-NC
A 50-something with chest pain presents to a Non-PCI capable facility

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

This ECG shows subtle anterior ST elevation with fragmented QRS and straightened ST segment. The cause was an occluded LAD stent, along with 90% stenosis of RCA and 70% circumflex stenosis.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation Normal ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Chest pain and Convex ST Elevation in Precordial Leads

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.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Normal Axis Anterior ST elevation Acute Inferior MI Acute Lateral MI 12-Lead Dr Smith's ECG Blog CC BY-NC
Anterior ST Elevation and a High Initial Troponin.

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.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Hyperacute T waves Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
Anterior STEMI Evolves to de Winter’s T-waves

This ECG is from a middle aged man who presented with chest pain.

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

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