Blog Ischemia STEMI 
Ken Grauer, MD
DECEMBER 1, 2023
For full discussion of this case — See ECG Blog #351 — == The ECG in Figure-1 — was obtained from a previously healthy older man who contacted EMS ( E mergency M edical S ervices ) because of "chest tightness" that began ~1 hour earlier. ECG Blog #205 = The Systematic Approach I favor. . =
Ken Grauer, MD
DECEMBER 15, 2023
For full discussion of this case — See ECG Blog #392 — == The ECG in Figure-1 was obtained from a man in his 60s — who described the sudden onset of "chest tightness" that began 20 minutes earlier, but who now ( at the time this ECG was recorded ) — was no longer having symptoms. ECG Blog #387 — Dynamic change in 2 minutes.
Ken Grauer, MD
DECEMBER 8, 2023
For full discussion of this case — See ECG Blog #292 — == The 2 ECGs shown in Figure-1 were obtained from a man in his 30s — who presented to the ED ( E mergency D epartment ) with chest pain that began several hours earlier. Related ECG Blog Posts to Today’s Case: ECG Blog #205 — Reviews my Systematic Approach to 12-lead ECG Interpretation.
Ken Grauer, MD
MARCH 15, 2024
By the P s, Q s, 3 R Approach ( which I review in ECG Blog #185 ): Lots of P waves are present — being well seen in the long lead II rhythm strip. This slight variation in sinus P wave regularity tends to be greater when a 2nd- or 3rd-degree AV block is present ( called ventriculophasic sinus arrhythmia — as shown in ECG Blog #344 ).
Ken Grauer, MD
AUGUST 26, 2023
These tall T waves are associated with flattening ( straightening ) of the ST segment in the inferior leads — with slight S T elevation in leads V2-thru-V6 ( albeit not enough to qualify as a "STEMI" — Akbar et al, StatPearls, 2023 ). This point is discussed in detail in the March 24, 2023 post of Dr. Smith’s ECG Blog ).
Ken Grauer, MD
MAY 20, 2023
Voltage for LVH is satisfied — at least by Peguero Criteria ( Sum of deepest S in any chest lead + S in V4 ≥23 mm in a woman — as discussed in ECG Blog #73 ). Smith's ECG Blog — Drs. Figure-3: Selected sets of V1,V2 leads from the examples of Precordial Swirl provided in the October 15, 2022 post in Dr. Smith's ECG Blog.
Ken Grauer, MD
AUGUST 8, 2024
PEARL # 3: While not 100% predictive — seeing a significant negative component to the P wave in these leads ( as per the YELLOW arrows in Figure-2 ) — suggests that the V1,V2 electrodes may be placed 1 or 2 interspaces too high on the chest ( See ECG Blog #274 — for more on too high placement of the V1,V2 electrode leads ).
Expert insights. Personalized for you.
165 
Let's personalize your content