ST elevation in V1

ST elevation in lead V1 without ST elevation in V2 can be a sign of right ventricular infarction, particularly when also seen with ST elevation in III > II and ST elevation in the right sided lead V4R.

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ECG Library (22)

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In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead ST elevation in aVR ST elevation in V1 Widespread ST depression Left main occlusion Dr Smith's ECG Blog CC BY-NC
How does acute left main occlusion present on the ECG?

This ECG is from a woman in her 50s who presented with 3 days of intermittent chest pain that became worse on the day of presentation, with diaphoresis and radiation to the left arm, as well as abdominal pain.

This ECG shows widespread ST depression with ST elevation in aVR and V1-2, due to a 100% left main occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Peaked T waves ST elevation in V1 Right ventricular MI Dr Smith's ECG Blog CC BY-NC
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician

This ECG is from a middle aged patient who presented with chest pain of uncertain duration.

This ECG shows ST elevation in V1 only. This was dynamic on serial ECGs. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Inferior ST elevation Peaked T waves Reciprocal ST depression ST elevation in V1 Right ventricular MI Dr Smith's ECG Blog CC BY-NC
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician – repeat ECG pain free

This ECG is from a middle aged patient who presented with chest pain of uncertain duration. This was the repeat ECG when pain returned.

This ECG shows ST elevation in V1, II, III and aVF with reciprocal ST depression in aVL. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.

In the ECGquest archives, this ECG has been tagged with: - Loss of consciousness 12-Lead Anterior ST depression Inferior ST depression Peaked T waves Right Axis Deviation ST elevation in aVL ST elevation in V1 Wide QRS Hyperkalemia Dr Smith's ECG Blog CC BY-NC
ST elevation in aVL with reciprocal ST depression in the inferior leads

This ECG is from a man in his 50s with a history of thyroid cancer was brought to the Emergency Department after being found minimally unresponsive with sonorous respirations on his couch at home. Blood glucose level was 76 mg/dL. EMS administered naloxone, which was followed quickly by hyperventilation but no improvement in mental status. EMS performed RSI at that time using etomidate and succinylcholine, but intubation was unsuccessful. Luckily, BVM ventilation was easy in this patient, and he was bagged on the way to the ED, with oxygen saturation maintained in the mid-90s. He was intubated immediately on arrival to the ED using ketamine and rocuronium. This was the initial ED ECG.

In the ECGquest archives, this ECG has been tagged with: - Loss of consciousness 12-Lead Serial 12-lead Anterior ST depression Inferior ST depression Peaked T waves Right Axis Deviation ST elevation in aVL ST elevation in V1 Wide QRS Hyperkalemia Dr Smith's ECG Blog CC BY-NC
ST elevation in aVL with reciprocal ST depression in the inferior leads – repeat after calcium

This ECG is from a man in his 50s with a history of thyroid cancer was brought to the Emergency Department after being found minimally unresponsive with sonorous respirations on his couch at home. Blood glucose level was 76 mg/dL. EMS administered naloxone, which was followed quickly by hyperventilation but no improvement in mental status. EMS performed RSI at that time using etomidate and succinylcholine, but intubation was unsuccessful. Luckily, BVM ventilation was easy in this patient, and he was bagged on the way to the ED, with oxygen saturation maintained in the mid-90s. He was intubated immediately on arrival to the ED using ketamine and rocuronium. This was the repeat ECG after calcium had been administered.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Serial 12-lead Excessive discordant ST elevation Pacemaker spikes ST elevation in V1 Wide QRS Acute Inferior MI Right ventricular MI Dr Smith's ECG Blog CC BY-NC
A 50-something with h/o coronary bypass has chest pain and a ventricular paced rhythm – 3, 16 min later

This ECG is from a man in his 50s who presented with chest pain on a background of previous CABG and dual chamber pacemaker. This was the repeat ECG 16 min after arrival.

This ECG shows a ventricular paced rhythm with excessive discordant ST elevation in III and aVF, and ST depression in aVL. The cause was an inferior and right ventricular infarction.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Serial 12-lead ST elevation in V1 Acute Inferior MI Acute Posterior MI Dr Smith's ECG Blog CC BY-NC
A male in his 50s with chest pain. What is your interpretation? – repeat ECG
In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Serial 12-lead ST elevation in aVL ST elevation in aVR ST elevation in V1 Widespread ST depression Proximal LAD occlusion Dr Smith's ECG Blog CC BY-NC
How can you persuade your cardiologist to take a Non-STEMI patient to the cath lab emergently? – 4