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.

Featured Example

References

ECG Library (163)

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In the ECGquest archives, this ECG has been tagged with: - Chest pain Chest leads Anterior ST elevation Hyperacute T waves Terminal QRS distortion Normal vs. abnormal anterior ST elevation Dr Smith's ECG Blog CC BY-NC
A 40-something healthy male with transient chest squeezing 31836

This ECG is from a man in his 40s who presented with intermittent chest tightness, shortness of breath and diaphoresis.

This ECG shows ST elevation in V1-6 and hyperacute T waves out of proportion to the size of the QRS. There is terminal QRS distortion in V3. The cause was an acute proximal LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Anterior ST elevation Pathological Q waves Old vs new ischemia Dr Smith's ECG Blog CC BY-NC
Unusual: Troponin Trajectory to Help Determine Ongoing/Recurrent Infarction vs. Completed Infarction. 31811

This ECG is from a man in his 40s who presented with a cough, shortness of breath and several episodes of chest pressure over the past week or so.

This ECG shows anterior ST elevation and deep QS waves. There was a 100% LAD occlusion that was approximately 2 weeks old.

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 31345

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? 31343

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 31380

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 31298

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? 31294

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 31283

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? 31281

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) 30625
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 30486

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 30450

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.

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