• Am J Emerg Med · Mar 2014

    Case Reports

    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.

    • Amal Mattu, Joseph Bledsoe, Mathew Goebel, and James L Orford.
    • Intermountain Medical Center, Murray, UT.
    • Am J Emerg Med. 2014 Mar 1;32(3):287.e5-8.

    AbstractCertain 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.

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