Send to

Choose Destination
Am J Emerg Med. 2014 Mar;32(3):287.e5-8. doi: 10.1016/j.ajem.2013.09.037. Epub 2013 Oct 2.

A new ST-segment elevation myocardial infarction equivalent pattern? Prominent T wave and J-point depression in the precordial leads associated with ST-segment elevation in lead aVr.

Author information

Intermountain Medical Center, Murray, UT.
Intermountain Heart Institute, Murray, UT.
University of Maryland School of Medicine, Baltimore, MD.
University of Virginia School of Medicine, Charlottesville, VA. Electronic address:


Certain acute coronary syndrome electrocardiographic (ECG) patterns, which do not include ST-segment elevation, are indicative of acute coronary syndrome caused by significant arterial occlusion; these patterns are, of course, associated with significant risk to the patient and mandate a rapid response from the health care team. One such high-risk ECG pattern includes the association of the prominent T wave and J-point depression producing ST-segment depression seen in the precordial leads coupled with ST-segment elevation in lead aVr. This ECG presentation is associated with significant left anterior descending artery obstruction. We report the case of a patient with this ECG presentation who progressed over a very short time to ST-segment elevation myocardial infarction of the anterior wall.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center