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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References

ECG Library (161)

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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: - Cardiac arrest Dyspnoea 12-Lead Anterior ST elevation Lateral ST elevation Sinus tachycardia LAFB RBBB Left main occlusion Dr Smith's ECG Blog CC BY-NC
How does acute left main occlusion present on the ECG? Case 2

This ECG is from a young woman who presented with sudden pulmonary oedema. This ECG was recorded just before she arrested.

This ECG shows sinus tachycardia, RBBB, LAFB and ST elevation in V2-6, I and aVL. The cause was a 100% left main occlusion.

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 12-Lead Anterior ST elevation Bifascicular block LAFB RBBB Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
What is the Diagnosis in this 70-something with Chest Pain?

This ECG is from a man in his 70s who presented with chest pain.

This ECG shows RBBB, LAFB and ST elevation V2-4. The troponin was very high due to a very large infarct. The cause was 3 vessel disease. The rhythm is also grouped, possibly bigeminy.

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: - 12-Lead Anterior ST elevation Fragmented QRS Left Axis Deviation ECG Interpretation CC-BY-NC-SA
ECG Blog #165 (MI – Acute – Old – Unknown Age – Aneurysm – Fragmentation)
In the ECGquest archives, this ECG has been tagged with: - 12-Lead Anterior ST elevation Inferior ST elevation Lateral ST elevation Normal ST elevation Normal vs. abnormal anterior ST elevation 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: - 12-Lead Anterior ST elevation Hyperacute T waves Inferior ST depression Lateral ST depression Acute Anterior MI 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 12-Lead Anterior ST elevation Hyperacute T waves Acute Anterior MI 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 12-Lead Anterior ST elevation Hyperacute T waves 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.

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