- = deeply inverted or biphasic T waves in V2-3, which is highly specific for a critical stenosis of the left anterior descending artery (LAD).
- Patients may be pain free by the time the EKG is taken and have normally or minimally elevated cardiac enzymes; however, they are at extremely high risk for extensive anterior wall MI within the next few days to weeks.
- Widespread horizontal ST depression, most prominent in leads I, II and V4-6
- ST elevation in aVR ≥ 1mm
- ST elevation in aVR ≥ V1
ST elevation is aVR is postulated to result from two possible mechanisms:
- Diffuse subendocardial ischaemia, with ST depression in the lateral leads producing reciprocal change in aVR due to a process causing generalized coronary ischemia (triple vessel disease, post cardiac arrest)
- Infarction of the basal septum, i.e. a STEMI involving aVR. aVR records electrical activity from the RVOT and the portion of the septum closest to the base (supplied by a proximal branch of the left main)
VT vs block with tachycardia:
Anomalous left coronary artery from pulmonary artery syndrome –> SCD
magnet –> converts pacemaker to fixed rate pacing