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Infarcts and Ischemia ECG 10

  1. Normal sinus rhythm
  2. ST changes consistent with ischemia - specifically, occlusion of the left main coronary artery

This ECG shows dramatic ST segment depression that is down-sloping — consistent with ischemia. The changes are quite pronounced. One classic teaching helps to diagnose a left main coronary artery occlusion; this is ST segment elevation in lead aVR greater than the ST elevation in lead V1, along with ST segment depression in the precordial leads.