Wednesday, February 9, 2011

Anterior hyperacute T-waves: look at this upside down mirror image

One reader who trained in France learned that a good way to see the ST elevation better is to look at a mirror image of the ECG (upside down).  I have done this in order to see that the ST depression in V2 of posterior STEMI is ST elevation when viewed upside down (as it would be recorded from a posterior aspect).  I have never seen it done to highlight inferior reciprocal ST depression and to highlight anterior hyperacute T-waves.

This is a case I posted last week:

Hyperacute T-waves in V2-V4, see full description at previous blog post
Upside Down Mirror Image.  Notice now that what was reciprocal ST depression in II, III, aVF is now ST elevation.  Also notice that the hyperacute T-waves, when pointing down, look to have ST depression.

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