70-year old patient presenting with chest pain and diaphoresis. Describe the ECG.
Describe and interpret this ECG
ECG ANSWER and INTERPRETATION
This is a very worrying ECG demonstrating massive anterolateral STEMI with “tombstone” morphology:
- Gross ST elevation in V1-6, I and aVL
- Early Q wave formation in aVL
- Reciprocal ST depression in inferior leads II, III and aVF
This ECG pattern is seen in proximal LAD occlusion and indicates a large territory infarction with a poor LV ejection fraction and high likelihood of cardiogenic shock and death.