Acute Extensive Anterior Infarction: Regaining R Waves
Report:
Sinus rhythm 60/min
Acute extensive anterior infarction
Comment:
Pathological Q waves are present in V2-3 after less than two hours of symptoms, possibly with some negative implications for the short-term outlook. Half an hour later, further ST segment elevation effaced them, lifting up many of the S waves as well (Fig 41A). Eventually, however, small R waves appeared, for the first time, in the anteroseptal leads (Fig 41b). The septal q disappeared from V5-6 as expected for anteroseptal infarcts.
The maximum ST segment elevation is, atypically, saddle-shaped. Nobody should mistake this for pericarditis – the elevation is more than 5 mm and the reciprocal changes in the inferior leads unequivocal.
The infarct has a signature of a proximal LAD artery lesion.
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