Anterior wall myocardial infarction
Hyperacute phase of anterior wall myocardial infarction – upsloping ST with tall T waves in V1-V4. This ECG was taken prior to thrombolytic therapy in the early phase of myocardial infarction.
This ECG was taken soon after thrombolysis and showed marked resolution of ST segment elevation, indicating successful thrombolysis with streptokinase. The T waves are still upright, but there is loss of R waves in V1-V3.
ECG taken the next day showing QS complexes in V1-V3 with mild ST segment elevation. Left axis deviation, possibly due to left anterior hemi block and a late diastolic ventricular ectopic beat (11th beat in the rhythm strip) are seen. The ectopic occurs soon after the sinus P wave. The ectopic beat is similar to the normal one in V1 while it shows subtle differences in V2 and V3. This also demonstrates the advantage of simultaneous multi-channel recording in the evaluation of arrhythmias.
ECG on third day shows a coved ST segment with T wave inversion in V2-V4 and QS complexes in V1-V2. T waves are inverted in inferior and lateral leads, indicating ischemia of inferior and lateral walls as well.
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