ST elevation myocardial infarction EKG examples

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

EKG Examples

Shown below is an EKG demonstrating the evolution of an infarct on the EKG. ST elevation, Q wave formation, T wave inversion, normalization with a persistent Q wave suggest STEMI.

Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:AMI_evolutie.png

Anterior Myocardial Infarction

Shown below is an EKG demonstrating loss of R waves throughout the anterior wall (V1-V6). QS complexes in V3-V5. ST elevation in V1-V5 with terminal negative T waves.

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Shown below is an EKG demonstrating acute anterior MI. LAD artery occlusion.

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Shown below is an EKG showing sinus rhythm with anteroseptal myocardial infarction depicting ST elevation in V1-V6 and in lead I.

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Shown below is an EKG demonstrating acute anterior myocardial infarction and left anterior hemiblock depicting ST elevation in precordial leads.

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Shown below is an EKG demonstrating old anterior myocardial infarction and bifascicular block (RBBB and LAHB) as indicated in the anterior chest leads.

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Shown below is an EKG illustrating acute MI with proximal LAD occlusion depicting ST elevation in anterior precordial leads.

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Shown below is an EKG demonstrating a 2 days old anterior infarction with Q waves in V1-V4 with persisting ST elevation, a sign of left ventricular aneurysm formation.

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Shown below is an EKG demonstrating a 2 weeks old anterior infarction with Q waves in V2-V4 and persisting ST elevation, a sign of left ventricular aneurysm formation.

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Shown below is an EKG demonstrating a large anterior wall infarction on admission. This image depicts ST elevation in V2-V5 leads.

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Shown below is an EKG showing ST elevation in the anterior precordial leads, low voltages in all the leads, poor R wave progression in the precordial leads.

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Shown below is an EKG demonstrating ST segment elevation in precordial leads signifying anterior myocardial infarction.

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Shown below is an EKG showing sinus rhythm with abnormal QRS and a Q wave in lead V2 which is suggestive of a previous anterior wall myocardial infarction.

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Anterolateral Myocardial Infarction

Shown below is an EKG demonstrating sinus rhythm. The remarkable feature is the poor R wave progression in the V1 and V2 leads and the ST elevation and T wave changes in leads V1 to V4 and I and aVL. The cardiogram suggests an anterior/ lateral MI possibly acute. There is also terminal P wave negativity in V1 suggesting a left atrial abnormality.

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Shown below is an EKG demonstrating acute myocardial infarction in in a patient with a pacemaker and LBBB. Concordant ST elevation in V5-V6 are clearly visible. There is discordant ST segment elevation > 5 mm in lead V3.

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Shown below is an EKG demonstrating findings in the same patient as in the first example 2 months before the myocardial infarction. Normal LBBB pattern.

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Shown below is an EKG showing ST elevation MI.

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Inferior Myocardial Infarction

Shown below is an EKG demonstrating ST elevation in the precordial and limb leads depicting acute inferior MI.

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Shown below is an EKG demonstrating changes during acute inferior MI depicting ST elevation in leads II, III and aVF.

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Shown below is an EKG demonstrating RBBB and inferior MI. Note to left axis deviation.

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Shown below is an EKG demonstrating lead V4R in a patient with RBBB and inferior MI, which clearly shows ST elevation.

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Shown below is an EKG demonstrating atrial fibrillation with inferior-posterior-lateral myocardial infarction and incomplete right bundle branch block. Lead I shows ST depression, suggestive of right coronary artery involvement.

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Shown below is an EKG showing ST elevation in inferior leads.

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Shown below is an EKG showing ST elevation MI.

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Shown below is an EKG showing ST elevation in inferior leads.

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Posterior Myocardial Infarction

Shown below is an EKG with ST elevation in II, III, aVF (in III > II), ST depression in I, aVL, V2. Tall R in V2, otherwise normal QRS morphology. The findings are suggestive of acute posteroinferior MI.

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Shown below is an EKG demonstrating changes during acute posterolateral MI depicting ST depression in precordial leads V2-V6.

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Infero-Posterior Myocardial Infarction

Shown below is an EKG with ST depression in V1, V4, tall R in V2. ST elevation in II, III, aVF, V5 and V6.

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Shown below is an EKG with sinus bradycardia with first degree AV block and inferior-posterior-lateral myocardial infarction.

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Shown below is an EKG depicting sinus bradycardia with inferior-lateral myocardial infarction.

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Shown below is an EKG illustrating inferior-posterior myocardial infarction with complete AV block and ventricular escape rhythm with RBBB pattern and left axis, followed by sinus rhythm.

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Shown below is an EKG demonstrating atrial fibrillation and inferior-posterior myocardial infarction.

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Shown below is an EKG demonstrating inferior-posterior-lateral myocardial infarction with a nodal escape rhythm

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Shown below is an EKG showing ST elevation MI.

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Shown below is an EKG showing ST elevation MI.

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Right Ventricular Myocardial Infarction

Shown below is an EKG demonstrating ST elevation in lead V1 and aVR; reversal of V6.

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Shown below is an EKG demonstrating STEMI changes in the right precordial leads.

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Shown below is an EKG demonstrating clear ST elevation in the right precordial leads. A coronary angiography revealed a proximal right coronary artery occlusion.

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