Do you recognize these ECGs? STEMI? LVH? What?

What do you think of these ECGs?I came across the first one reading it blind for a study.  I was certain I knew the diagnosis, and went to the chart to confirm.The first 3 were recorded on one day.ECG 1:ECG 2:ECG 3:ECG 4, recorded 12 days later:These ECGs are classic for abenign variant in Black males.  I was certain it would be a relatively young black male without cardiac pathology.Result from chart:It was a black male in his 40s.The first ECG, and then the next two (1-3), were recorded for chest and abdominal pain.  The patient was ultimately diagnosed with biliary colic.The patient ruled out for MI by serial trops.The second presentation (ECG 4) was for epigastric pain due to GERD.After ruling out for MI both times, the formal ECG diagnosis was LVH. But we know that this pattern is nearly always a normal pattern for black men (although one cannot be 100% certain and an echo is important especially to rule out hypertrophic cardiomyopathy).An echocardiogram was completely normal.  No LVH.See this article published this month by Brooks Walsh, Smith, and others in Journal of Electrocardiology: Distinctive ECG patterns in healthy black adultsJournal of ElectrocardiologyVolume 56, September –October 2019, Pages 15-23
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs