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All ECG 34

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Source: Learn the Heart

The ECG shows normal P waves at 100 beats per minute conducted 1:1 with a normal PR interval of about 0.16 sec. In the frontal plane leads, the initial forces are downward (small R wave II-III-AVF) and to the right (small Q in lead I) with prominent terminal forces upward and to the left (deep S in II, III, AVF and tall R in AVL). There are very small R waves in V1-4 with 2 mm ST-segment elevations. The changes are consistent with an acute anterior ST-elevation myocardial infarction.

This patient had an acute occlusion of the left anterior descending coronary artery in the mid-portion, after the first major septal branch (V1 is not involved) and after a large diagonal branch (no lateral extension, V5 and V6 appear normal).

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