Massive ‘Reciprocal’ Changes

Report:

Sinus rhythm

PR interval 0.20”

Acute lateral infarction

Widespread reciprocal ST segment depression

Comment:

It never, of course, quite certain how much of the ST depression is indeed reciprocal to the puny elevation in aVL and how much is independent ischæmia. As a general rule, however, the elevation is the primary event70 when associated with depression in other leads.

Taking leads V4-6 one interspace higher is sometimes employed to bring to light more of the ‘lateral’ infarct pattern; it is rarely successful and never relevant in the first place.

This patient died from cardiogenic shock.

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