CVA: Anterolateral ST Segment Elevation

Report:

Atrial fibrillation with rapid ventricular response.

VEB.

Anterolateral ST segment elevation consistent with MI or ischæmia.

Left ventricular hypertrophy.

Comment:

The patient had no clinical evidence of MI. Note the reciprocal - discrete but definite - ST segment depression in V2-4. An acute MI could not be excluded on ECG grounds alone. The following day (Fig 219a) the T waves inverted in V5-6: it remains unknown whether this represented reversion to her baseline pattern or progression of whatever myocardial injury the CVA itself had inflicted. She died the following day.

The report makes no mention of the (non-specific) ST/T changes elsewhere in the ECG. It would be rather pedantic to list them beside the acute changes present in the anterolateral leads.

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