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** **ACUTE MI/STEMI** **: Activate the cath lab if the patient has chest pain?

Dr. Smith's ECG Blog

This ST-T wave pattern in lead V5 is not seen in other leads, as would be expected if this was truly a change of acute ischemia. I attributed the diffuse ST-T wave changes to LV "strain" and not ischemia. What about the R = S Phenomenon in the Inferior Leads? Conclusion: The ECG in today's case is notable for marked LVH.