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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

1
Intermountain Medical Center, Murray, UT.
2
Intermountain Heart Institute, Murray, UT.
3
University of Maryland School of Medicine, Baltimore, MD.
4
University of Virginia School of Medicine, Charlottesville, VA. Electronic address: wb4z@virginia.edu.

Abstract

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.

PMID:
24176590
DOI:
10.1016/j.ajem.2013.09.037
[Indexed for MEDLINE]

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