ECG Quest > Shapes > QRS complex > Terminal QRS distortion

Terminal QRS distortion

Terminal QRS distortion occurs when there is ST elevation and neither an S wave nor a J wave is present. This applies to either lead V2 or V3. This may suggest that LAD occlusion is more likely than normal variant early repolarisation.

This sign is not well known and can be missed.

See also: QRS complex

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In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement Hyperacute T waves Late R wave transition Terminal QRS distortion Acute Anterior MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic

This ECG is from a woman in her 60s who presented with chest pain and feeling clammy, on a background of hypertension and high cholesterol. This was her first prehospital ECG.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement Anterior ST elevation Hyperacute T waves Terminal QRS distortion Acute Anterior MI 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic: 2 – En route to cath center

This ECG is from a woman in her 60s who presented with chest pain and feeling clammy, on a background of hypertension and high cholesterol. This was her second ECG en route to the hospital.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement Anterior ST elevation Hyperacute T waves Terminal QRS distortion Acute Anterior MI 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic: 3 – En route to cath center

This ECG is from a woman in her 60s who presented with chest pain and feeling clammy, on a background of hypertension and high cholesterol. This ECG was recorded en route to the hospital.

In the ECGquest archives, this ECG has been tagged with: - Chest pain High V1/V2 misplacement Anterior ST elevation Hyperacute T waves Terminal QRS distortion Acute Anterior MI 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Prehospital OMI recognized immediately by a fantastic paramedic: 4 – En route to cath center

This ECG is from a woman in her 60s who presented with chest pain and feeling clammy, on a background of hypertension and high cholesterol. This ECG was recorded en route to the hospital.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Terminal QRS distortion Acute Anterior MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Watch what happens when “pericarditis” and morphine cloud your judgment

This ECG is from a man in his 50s who presented with chest pain on a background of prior coronary artery disease including LAD stent. This was his initial ECG.

In the ECGquest archives, this ECG has been tagged with: - Terminal QRS distortion 12-Lead Dr Smith's ECG Blog CC BY-NC
Paper published: Terminal QRS distortion not found in any ECG of Early Repolarization
In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Hyperacute T waves Tall QRS Terminal QRS distortion Myocarditis 12-Lead Dr Smith's ECG Blog CC BY-NC
A 30 year old with Chest Pain, Anterior ST Elevation, Terminal QRS distortion, and a High Troponin