tag:blogger.com,1999:blog-549949223388475481.post4105530975386036332..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: 40-something with severe CP. True + vs. False + high lateral MI. ST depression does not localize.Unknownnoreply@blogger.comBlogger1125tag:blogger.com,1999:blog-549949223388475481.post-30981271325478523352016-09-05T02:49:08.018-05:002016-09-05T02:49:08.018-05:00GREAT post! Dr. Smith thoroughly covers all essent...GREAT post! Dr. Smith thoroughly covers all essentials in this case. A few quick thoughts I’d add are: i) Shape is much more important than amount of ST segment deviation. The shape of the ST-T wave in the original ECG presented in this case is clearly abnormal in multiple leads (the subtle-but real ST elevation in leads I,aVL; reciprocal ST-T wave changes in leads III,aVF; and either flat ST segment and/or abrupt angulation in the area of transition between ST segment and T wave in leads II and all 6 chest leads). Other than perhaps aVR — there are no truly normal leads here.<br /><br />ii) Think “mirror image” when looking for reciprocal changes. If you imagined a horizontal mirror running across the tracing in between lead III and lead aVL — then flipping lead III up would give you the picture we see in aVL, and vice versa.<br /><br />iii) Dr. Smith’s pearl about the “down-up” T wave in lead aVF (subtle as it is) — is truly telling (ie, confirmatory).<br /><br />THANKS for posting this case!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.com