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Goebel M, Bledsoe J, Orford JL, et al. 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. 2013;32(3):287.e5-8doi: 10.1016/j.ajem.2013.09.037.
Goebel, M., Bledsoe, J., Orford, J. L., Mattu, A., & Brady, W. J. (2014). 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. The American journal of emergency medicine, 32(3), 287.e5-8. https://doi.org/10.1016/j.ajem.2013.09.037
Goebel, Mathew, et al. "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." The American journal of emergency medicine vol. 32,3 (2014): 287.e5-8. doi: https://doi.org/10.1016/j.ajem.2013.09.037
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 Mar;32(3):287.e5-8. doi: 10.1016/j.ajem.2013.09.037. Epub 2013 Oct 02. PMID: 24176590.
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Am J Emerg Med. 2014 Mar;32(3):287.e5-8. doi: 10.1016/j.ajem.2013.09.037. Epub 2013 Oct 02.

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.

The American journal of emergency medicine

Mathew Goebel, Joseph Bledsoe, James L Orford, Amal Mattu, William J Brady

Affiliations

  1. Intermountain Medical Center, Murray, UT.
  2. Intermountain Heart Institute, Murray, UT.
  3. University of Maryland School of Medicine, Baltimore, MD.
  4. University of Virginia School of Medicine, Charlottesville, VA. Electronic address: [email protected].

PMID: 24176590 DOI: 10.1016/j.ajem.2013.09.037

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.

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