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Arrhythmia Recognition Webcast Series
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Practice ECG 24
This is not a subtle ECG. What stands out the most are the ST segments of the anteroseptal precordial leads from V1 to V5. The ST segments are flat and associated with inverted T waves. These are the changes found in an acute anteroseptal AMI with lateral extension. There are, however, some subtle changes that you should notice. Look at aVL. Notice the slight elevation of the ST segments in that lead. Now, look at the ST segments in the inferior leads of II, III, and aVF. They are depressed. The inferior depression is caused by reciprocal changes from the lateral extension of the AMI.
To round off the discussion, we need to mention the LAE, LVH, and QT prolongation on this ECG. The axis is in the left quadrant and there is evidence of a possible left anterior hemiblock.
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