Question 6.4

1. Describe the ECG shown. 

2. Which coronary artery territory may be involved in the pathophysiology of this case?

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College Answer

1 Sinus rhythm of 92 bpm. ST elevation of >2mm in II, III AVF and V5,6 with reciprocal changes in V1 and AVR. Consistent with myocardial infarction or pericarditis

2 Right coronary artery territory or LCx if dominant left system


This is another "what ECG is this?" question, made harder to discuss because the college has removed the ECG from its paper.

Thankfully, I was able to find an example of an infarct with prciely these characteristics, as well an erudite discussion of its finer points.

This bounty is available for all to see at EMS12Lead.


No published evidence is possible or necessary.

However, EMS12Lead has pointed me to an article which may be of interest, if for no other reason then at least because it is by Sgarbossa et al (yes, that Sgarbossa).

Sgarbossa et al., Electrocardiographic diagnosis of acute myocardial infarction: Current concepts for the clinician. Am Heart J. 2001;141:507-17