Using ECG’s from a large database the authors described a new ECG pattern without ST elevation, that indicated proximal left anterior descending(LAD) coronary artery occlusion.
The pattern was seen in the precordial leads and comprised:
-ST segment depression at the J point of precordial leads of at least 1mm
-Upsloping ST segments, becoming
-Peaked positive symmetrical T waves
-aVR also showed small ST Elevation (1-2mm)
This pattern was recognised in 2% of patients (30/1532) with anterior myocardial infarction.
It was described as a static pattern, rather than evolving with changes to the ST segments. Since then other studies have shown evolution to classic STEMI does occur.
This is now considered to be an anterior STEMI Equivalent.
In 2009 Verovden el al (2) duplicated these findings in patients with anterior wall myocardial infarction. The distinct ECG pattern was identified in approximately 2% of patients with LAD stenosis, in that study also. These patients were more likely to be younger and male and tended to have hypercholesterolaemia.