Another Proximal LAD Lesion

Report:

Sinus tachycardia 133/min

(Hyper)acute anterior infarction

Comment:

The indicative ST/T changes are in the anteroseptal leads and include lateral leads 1 and aVL. There is also marked reciprocal depression in the inferior leads. These are both signs of proximal LAD disease.

In anteroseptal infarcts, Q waves Q waves are commonly shared with 1 and aVL, unlike the inferior ones, which tend to have Q in V4-6 (called inferolateral conventionally and usually due to circumflex disease)34.

The hyperacute pattern rapidly dissipated with thrombolysis (below, two hours later, Fig 37a), but a non-Q infarction (not shown) remained.

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