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: - 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.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Normal Axis Normal rate Regular Anterior ST elevation Acute Anterior MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Is this ST elevation normal or abnormal?

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.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation Tall QRS LVH 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Profound ST Elevation in V1-V3. What do you think?

This ECG is from a patient of unknown age who had a systolic BP of 220 mm HG and no ischemic symptoms.

This ECG shows tall QRS complexes meeting LVH criteria with anterior ST elevation. Echo confirmed marked left ventricular hypertrophy only.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation Inverted T waves Normal Sinus Rhythm Old anterior MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Two cases of ST Elevation with Terminal T-wave Inversion – do either, neither, or both need reperfusion?

This ECG is from a man of unknown age who had cardiac stents placed 2 months ago.

This ECG shows sinus rhythm with QS-waves and ST elevation in V1-V3, with some terminal T-wave inversion. Serial troponins and angiography was normal.

In the ECGquest archives, this ECG has been tagged with: - Abdominal pain Chest pain Anterior ST elevation Normal ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Saddleback ST Elevation. Is it STEMI? Is it type II Brugada? Repeat ECG.

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

This ECG shows normal variant ST elevation.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Inferior ST depression ST elevation in aVL LAFB Mid-anterior MI 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Thrombus propagation on 10 serial Prehospital ECGs: Can you explain the progression?

This ECG is from a patient of unknown age who presented with chest pain. This was the repeat ECG 19 minutes later.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Anterior ST elevation Inferior ST elevation Lateral ST elevation Reciprocal ST depression Acute Anterior MI Acute Inferior MI 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Is this a STEMI? No, not by definition! Why not? Why is this Important?

This ECG is from a man in his 40s presented with dyspnoea, left arm numbness and some chest tightness for 1.5 hours. This was his repeat ECG after sublingual nitroglycerine improved his symptoms.

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