This is a very interesting ECG taken from an acute M.I. patient. Your basic level students will be able to appreciate the ST elevation in V1 through V3. Although the elevations are not very high, there are plenty of other abnormalities that point to acute STEMI: the ST segments are flat and there are marked ischemic T waves in the lateral leads: V4 through V6 and I and aVL. The patient was suffering an acute episode of chest pain.
It is also noticeable that R wave progression in the precordial leads (V1 through V6) is not optimal, as there is still a significant S wave in V6. We do not know if this is an electrode placement issue or not. The QT interval is just at the high limit of normal.
For your more advanced students, aVR has ST elevation. It is not reciprocal of an ST depression in Lead II. Research has shown that ST elevation in aVR and V1, especially when the ST elevation is greater in aVR, is a strong indication of proximal LCA or a Left Main occlusion. Unfortunately, we do not have cath results for this patient. In acute M.I. patients, higher mortality rate has been associated ST elevation in aVR.
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