ST elevation myocardial infarction EKG examples
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
For the main page on ST elevation MI, click here.
ST Elevation Myocardial Infarction EKG Examples
Shown below is an example of an ECG of STEMI demonstrating the evolution of an infarct on the ECG. ST elevation, Q wave formation, T wave inversion, normalization with a persistent Q wave.
Shown below is an example of ECH illustrating pathologic ST elevation.
Shown below is an example of ECG demonstrating ST elevation in lead V1 and aVr; reversal of V6.
Shown below is an example of ECG demonstrating acute inferior ST segment elevation MI (STEMI). Note the ST segment elevation in leads II, III, and aVF along with reciprocal ST segment depression in leads I and aVL.
Shown below is an example of ECG illustrating Acute inferior myocardial infarction with RV involvement.
Shown below is an example of ECG demonstrating STEMI changes in the right precordial leads
Shown below is the EKG recording shows sinus rhythm. The remarkable feature is the some what 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.
Shown below is an example of ECG illustrating acute inferior MI. ST elevation in the precordial and limb leads.
Shown below is an example of ECG showing Acute inferoposterior MI: ST elevation in II, III, AVF (in III > II). ST depression in I, AVL, V2. Tall R in V2, otherwise normal QRS morphology.
Shown below is an example of ECG demonstrating changes during acute inferior MI.
Shown below is an example of ECG demonstrating changes during acute posterolateral MI
Shown below is an example of ECG showing acute inferolateral MI: ST depression in V1, V4, tall R in V2. ST elevation in II, III, AVF, V5 and V6.
Shown below is an example of ECG demonstrating cute anterior MI. 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.
Shown below is an example of ECG with sinus bradycardia with first degree AV block and inferior-posterior-lateral myocardial infarction.
Shown below is an example of ECG showing sinus bradycardia with inferior-lateral myocardial infarction.
Shown below is an example of ECG demonstrating acute anterior MI. LAD artery occlusion.
Shown below is an example of ECG showing sinus rhythm with anteroseptal myocardial infarction.
Shown below is an example of ECG demonstrating sinus rhythm with left bundle branch block, comparison with an old EKG is mandatory to evaluate whether the LBBB is new (a sign of myocardial infarction) or old.
Shown below is an example of ECG illustrating inferior-posterior myocardial infarction with complete AV block and ventricular excape rhythm with RBBB pattern and left axis, followed by sinus rhythm.
Shown below is an example of ECG showing acute anterior myocardial infarction and left anterior hemiblock.
Shown below is an example of ECG demonstrating old anterior myocardial infarction and bifascicular block (RBBB and LAHB)
Image courtesy of Dr Jose Ganseman
Shown below is an example of an ECG illustrating acute MI with proximal LAD occlusion.
Shown below is an example of ECG demonstrating a 2 days old anterior infarction with Q waves in V1-V4 with persisting ST elevation, a sign of left ventricular aneurysm formation.
Shown below is an example of ECG demonstrating a 2 weeks old anterior infarction with Q waves in V2-V4 and persisting ST elevation, a sign of left ventricular aneurysm formation.
Shown below is an example of an ECG demonstrating a large anterior wall infarction on admission.
Shown below is an example of an ECG demonstrating ventricular fibrillation with increased heart rate and presence of two extra systoles short after each other.
Shown below is an example of an ECG demonstrating a trial fibrillation and inferior-posterior myocardial infarction.
Shown below is an example of an ECG demonstrating clear ST elevation in the right precordial leads. A coronary angiography revealed a proximal right coronary artery occlusion.
Shown below is an example of an ECG demonstrating inferior-posterior-lateral myocardial infarction with a nodal escape rhythm
Shown below is an example of an ECG demonstrating RBBB and inferior MI. Note to left axis deviation.
Shown below is an example of an ECG demonstrating lead V4R in the same patient with RBBB and inferior MI clearly shows ST elevation.
Shown below is an example of an ECG demonstrating cute 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.
Shown below is an example of an ECG demonstrating findings in the same patient as in the first example 2 months before the myocardial infarction. Normal LBBB pattern.
Shown below is an example of an ECG demonstrating acute MI in a patient with LBBB
Shown below is an example of an ECG demonstrating Wellens' sign in proximal LAD lesion; characterized by symmetrical, often deep >2mm, T wave inversions in the anterior precordial lead; classically occurs during pain free period
Shown below is an example of an ECG 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.
Shown below is an example of an ECG demonstrating ypical negative T waves post anterior myocardial infarction. This patient also shows QTc prolongation. Whether this has an effect on prognosis is debated. [1][2][3]
Shown below is an example of an ECG showing ST elevation in the anterior precordial leads, low voltages in all the leads, poor R wave progression in the precordial leads.
Shown below is an example of ECG demonstrating ST segment elevation in precordial leads signifying anterior myocardial infarction.
Sources
Copyleft images obtained - courtesy of ECGpedia, [2]
References
- ↑ Novotný T, Sisáková M, Floriánová A; et al. (2007). "[QT dynamicity in risk stratification in patients after myocardial infarction]". Vnitr Lek (in Czech). 53 (9): 964–7. PMID 18019666. Unknown parameter
|month=ignored (help) - ↑ Jensen BT, Abildstrom SZ, Larroude CE; et al. (2005). "QT dynamics in risk stratification after myocardial infarction". Heart Rhythm. 2 (4): 357–64. doi:10.1016/j.hrthm.2004.12.028. PMID 15851335. Unknown parameter
|month=ignored (help) - ↑ Chevalier P, Burri H, Adeleine P; et al. (2003). "QT dynamicity and sudden death after myocardial infarction: results of a long-term follow-up study". J. Cardiovasc. Electrophysiol. 14 (3): 227–33. PMID 12716101. Unknown parameter
|month=ignored (help)