title: A new ST-segment elevation myocardial infarction equivalent pattern? Prominent T wave and J-point depression in the precordial leads associated with ST-segment elevation in lead aVr.
abstract: Certain acute coronary syndrome electrocardiographic (ECG) patterns, which do not include ST-segment elevation, are indicative of acute coronary syndrome caused by significant arterial occlusion; these patterns are, of course, associated with significant risk to the patient and mandate a rapid response from the health care team. One such high-risk ECG pattern includes the association of the prominent T wave and J-point depression producing ST-segment depression seen in the precordial leads coupled with ST-segment elevation in lead aVr. This ECG presentation is associated with significant left anterior descending artery obstruction. We report the case of a patient with this ECG presentation who progressed over a very short time to ST-segment elevation myocardial infarction of the anterior wall.
authors.affiliation: Intermountain Medical Center, Murray, UT.
authors.forename: Mathew
authors.initials: M
authors.lastname: Goebel
authors.affiliation: Intermountain Medical Center, Murray, UT.
authors.forename: Joseph
authors.initials: J
authors.lastname: Bledsoe
authors.affiliation: Intermountain Heart Institute, Murray, UT.
authors.forename: James L
authors.initials: JL
authors.lastname: Orford
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Amal
authors.initials: A
authors.lastname: Mattu
authors.affiliation: University of Virginia School of Medicine, Charlottesville, VA. Electronic address: wb4z@virginia.edu.
authors.forename: William J
authors.initials: WJ
authors.lastname: Brady
mesh_terms: D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology