@JoePinero
As if there weren’t enough morphologies and subtleties in the EKG, here is another ekg finding that you should be aware of…
de Winter T-waves
- 1-3 mm ST-depression upsloping at the J-point in the mid precordial leads leading to tall symmetric T-waves
- No large studies on the topic
- Several small case series show correlation with acute LAD occlusion
References
de Winter RJ, Verouden NJ, Wellens HJ, Wilde AA. A new ECG sign of proximal LAD occlusion. N Engl J Med. 2008 Nov 6;359(19):2071-3
Rokos IC, French WJ, Mattu A, et al. Appropriate cardiac cath lab activation: optimizing electrocardiogram interpretation and clinical decision-making for acute ST-elevation myocardial infarction. Am Heart J. 2010 Dec;160(6):995-1003
For a much more thorough look into this topic check out this paper…
Goebel M, Bledsoe J, Orford JL, Mattu A, Brady WJ. 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. Am J Emerg Med 2014;32(3):287.e5–8.
Credit to Dr. Mattu’s ekg site for highlighting this interesting ekg finding
