A 50-something with cocaine chest pain and ST Elevation in V1 - V3

CONCLUSIONS -- SUMMARY Moderately increased left ventricular wall thickness.Normal left ventricular size and systolic function with an estimated EF of 68%.No regional wall motion abnormality.Dynamic intracavitary gradient, peak 34 mmHg at rest and mmHg with Valsalva.Indeterminate left-sided diastolic parameters.  The hypertrophy is somewhat more prominent at the apex. This, in conjunction with the dynamic intracavitary gradient, raisesconcern for hypertrophic cardiomyopathy. Learning PointsRight precordial ST Elevation: Septal STEMI vs. LVH:Here is a typical case of massive LVH, with secondary ST Elevation in V1 and V2.  Note that there is a QS-wave in V1, STE is in V1 and V2, there is ST depression in V5 and V6,with negative T-waves in V5 and V6.Notice the T-waves are negative in V5 and V6Examples of Septal STEMI.Note that, even though there is ST depression in V5 and V6 (reciprocal to the STE in right precordial leads),there is no T-wave inversion in V5-V6!)A man in his 50s with " gas pain "Developed into this:A woman in her 70s with chest painChest Pain and RBBB. What do you think?Chest pain in a patient with previous inferior STEMI. Scrutinize both the ECG and the history!Septal STEMI with lateral ST depression, then has collateral reperfusion resulting in Wellens ' wavesSeptal STEMI with ST elevation in V1 and V4R, and reciprocal ST depression in V5, V6This is a Septal OMI.  Full LAD Occlusion with STE in V1-V3, STD in V5 and V6, but do...

Source: Dr. Smith's ECG Blog - February 9, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs