A teenager with chest pain, a troponin below the limit of detection, and " benign early repolarization "

Sent by anonymous, written by Pendell MeyersA male in his teens presented with complaints of chest discomfort and dyspnea beginning while exercising but without obvious injury. He immediately stopped exercising and symptoms started to improve. Later that evening he felt recurrent central chest discomfort, shortness of breath, and vomited. Symptoms have been constant since this second episode, and are still present on arrival, which seems to have been less than 1 to 2 hours from onset of symptoms. No similar symptoms in the past. No prior exertional complaints of chest pain, dizziness, lightheadedness, or undue shortness of breath. No family history of sudden cardiac death, cardiomyopathy, premature CAD, or other cardiac issues. He denied headache or neck pain associated with exertion.Initial vitals: BP 116/84, RR 36, HR 85 bpm, SpO2 98% on RAWhat do you think?Meyers ECG Interpretation: Easily diagnostic of LAD occlusion. Sinus rhythm, normal QRS (except for the poor R wave progression from the LAD OMI), then very obvious STE from V2-V6, Hyperacute T-waves in V2-V6, I, aVL, II, III, also TQRSD in V6 (only describedas diagnostic of OMIif in V2-V3 in literature thus far). This is not " diffuse " , this is simply anterior, lateral, and likely apical. 50% of LAD STEMIs do not have reciprocal findings in inferior leads, and many LAD OMIs instead have STE and/or HATWs in inferior leads instead. The ECG easily meets STEMI criteria in all leads V2-V6, as well. This was sent to me...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs