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.

If you have any suggestions for or feedback on this report, please let us know.