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Infarcts and Ischemia ECG 7

  1. Sinus tachycardia
  2. Acute anterior myocardial infarction

This ECG demonstrates an “extensive anterior” and “tombstoning” of the ST segment seen during a large acute anterior myocardial infarction. This is usually the result of thrombosis of the left anterior descending coronary artery. In this ECG, the thrombosis would be proximal in the left anterior descending because the septal leads (V1 and V2) are involved. Also, note the inferior changes. Some left anterior descending coronary arteries wrap around the cardiac apex, and can supply part of the inferior wall as well, which was indeed the case in this situation.