A 53 year old with chest pressure has a diagnostic EKG (EKG 1). What is it? Chest pressure resolves (EKG 2)

A 50-something male had onset of pain approximately 30 min prior to arrival and was still present on arrival.  The pain was described as a pressure with radiation to his back. No nausea or SOB. No diaphoresis. He had never had this pain before.Computer and physician read:SINUS RHYTHMMODERATE ST DEPRESSION [0.05+ mV ST DEPRESSION]What do you think?After looking, compare with the patient ' s previous ECG (next), and then see what you think.There is ST Elevation in V2 and V3Previous ECG from 3 months prior, during a visit for angioedema:This ECG is normal, with a bit of normal ST elevation in V2 and V3The first ECG above: ST Elevation, but not enough to meet STEMI criteria of 2 mm in both V2 and V3 (for a male over age 40).  There is also ST depression in II, III, aVF and V5, V6.  There are large T-waves.That first ECG, by itself, without comparing with the previous ECG, is diagnostic of acute LAD occlusion.ST elevation is sometimes normal and sometimes not.  How do you tell the difference?  See more complete discussion below.As for this first ECG:Normal ST elevation NEVER has associated ST depression. This ECG has ST depression in inferior leads (it also has a touch of ST elevation in aVL)AND there is ST depression in V5 and V6. This is diagnostic of an acute LAD occlusion. Comparison with the previous ECG, which barely has any normal ST elevation, proves that this is New, and ischemic, ST Elevation.Additionally: the T-waves are...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs