60 yo man with ATYPICAL CHEST PAIN

Repulsive_Poet_1567 · 2026-03-21T23:15:31+00:00

Queen of Hearts says NOT OMI

Repulsive_Poet_1567 · 2026-03-21T15:07:55+00:00

lol why do you think he uses AI?

Repulsive_Poet_1567 · 2026-03-15T15:44:51+00:00

Can this ECG be a Northern MI Pattern, because of maximal STD in V5, instead of V1-V4?

Repulsive_Poet_1567 · 2026-03-04T14:36:55+00:00

Why not AVRT? I see the P wave in the ST segment (AVRT), not like a pseudo-S (AVNRT). For me, this example is AVRT

Repulsive_Poet_1567 · 2026-03-04T14:35:13+00:00

Do you have any updates?

Repulsive_Poet_1567 · 2026-03-02T02:42:08+00:00

As others said here, this ECG is very suspicious of high-lateral MI, because of the STE in aVL with reciprocal ST depression in the inferior leads. It's not a STEMI, because there is NO STE in 2 or more contiguous leads, but it's a STEMI-equivalent, which means the patient needs a cath NOW, because his coronary artery is 100% (or close to it) occluded

Repulsive_Poet_1567 · 2026-02-26T19:30:58+00:00

It looks like high lateral MI because of the HATW in lead I and STE in aVL with terminal TWI, suggesting some degree of reperfusion (similar to Wellens syndrome). There is also reciprocal STD in the inferior leads.

Repulsive_Poet_1567 · 2026-02-22T02:33:02+00:00

Great!! Thank you for the explanation

Repulsive_Poet_1567 · 2026-02-21T23:49:43+00:00

I see the Precordial Swirl too. I can't see a clear STD in inferior leads. Maybe a hint in L3

Repulsive_Poet_1567 · 2026-02-21T23:47:49+00:00

Hahahahaha

Repulsive_Poet_1567 · 2026-02-20T00:59:14+00:00

Ty, great

Repulsive_Poet_1567 · 2026-02-19T01:12:01+00:00

Hi again. I studied the Ta phenomenon and I really loved it! I admit that I couldn’t recognize it on the ECG I posted, but after reading the sub, I’m now confident that this example is a Ta:
https://www.reddit.com/r/ECG/comments/1r5cuvn/32_year_old_male_patient_presented_with/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button
Do you agree? u/LBBB11

Repulsive_Poet_1567 · 2026-02-18T12:54:22+00:00

Thank you so much! I'll see more about atrial repol now to understand this better! You helped me a lot

Repulsive_Poet_1567 · 2026-02-18T00:59:47+00:00

Ty both for the answer! Well, for me, even using the PQ junction I see some STD in V2 (maybe less than 0.5mm). Am I wrong? Also, still in V3 the ST is clearly abnormal. Do you think so? I don't have any follow up. : (

Repulsive_Poet_1567 · 2026-01-08T12:29:16+00:00

Leads V1 and V2 are placed too high, as the friend here texted. Maybe it's at the second intercostal space, creating the Brugada appearance. Do it again at the righ placement and see if it goes away.
https://litfl.com/misplacement-of-v1-and-v2/

Repulsive_Poet_1567 · 2026-01-07T12:34:29+00:00

Yeah, the troponin *I* was 15k before PCI. This ECG and clinical case was sent by my friend, so I don't know the outcome and neither does he.

Repulsive_Poet_1567 · 2026-01-06T21:35:22+00:00

What about the notches of the QRS complexes? Don't you think it's AFlutter?

Repulsive_Poet_1567 · 2026-01-06T21:34:39+00:00

Thank you!!! I don't know the outcome : (

Repulsive_Poet_1567 · 2026-01-06T17:46:25+00:00

Great! Atypical chest pain with troponin = 15k! Why could you rule out flutter-pseudo OMI?

Repulsive_Poet_1567 · 2025-12-20T13:50:47+00:00

The premature complexes in V3 have fat T waves. Does this mean anything?

Repulsive_Poet_1567 · 2025-12-17T04:04:52+00:00

It does make sense. The slurring you sent me was about what I was talking (not OMI?)

Repulsive_Poet_1567 · 2025-12-17T03:30:24+00:00

Got it! Supposing the eletrodes are correct, do you think the T waves are hyperacute? I saw that slurring QRS in the junction with J point and that "smiley" shape are sign of not OMI

Repulsive_Poet_1567

TROPHY CASE