Thursday, October 8, 2009

Left Ventricular Hypertrophy May Result in Profound ST Elevation

This 75 year old man presented with weakness. His blood pressure was 220/80. He was found to have renal failure. He ruled out for MI.

There are 4 mm of ST elevation in leads V2 and V3, but it not out of proportion to the very large (> 50 mm) preceding S-wave. This is typical of severe LVH with repolarization abnormalities.

It would be an unusual EKG for anterior STEMI.

In fact, it is very difficult to find a case of anterior MI with extreme voltage like this; this is probably because profound ischemia of LAD occlusion (STEMI) alters the QRS voltage and attenuates the severity of the electrocardiographic LVH voltage.

If anyone out there has such a case (proven LAD occlusion with very large voltage suggestive of LVH), please send it to me!

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