Reversible ST Segment Depression Myocardial Infarction

Report:

Atrial fibrillation with ventricular response 65 – 103/min

Precordial ST segment depression c/w infarction/ischæmia

Comment:

The CPK showed a rise to 900 U/L, while the troponin remained, unaccountably, negative. Later it transpired that there was a “bad batch” in the laboratory!

The ST segments normalised within 5 hours, but the T waves grew bigger (Fig 53a). Perhaps that was it: T inversion over the (invisible) posterior wall. Another feature of interest is the V2 – V3 lead reversal.

53a. V2 and V3 are reversed, but both show unusually prominent T waves.

54. 50 year old man admitted three hours previously with (now settled) chest pain.

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