Chest Pain has "Gone On Long Enough"
Clinician Reviews. 2011 September;21(9):
September 21, 2011|Clinician Reviews
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The correct interpretation of this ECG includes normal sinus rhythm, left atrial enlargement, and an anteroseptal myocardial infarction.
The diagnostic criteria for left atrial enlargement include a P-wave duration of ≥ 120 ms in lead II and/or a terminal negative component of a biphasic P wave in lead V1. In this example, the biphasic P wave is better seen in lead V2, while a large negative P wave is present in V1.
The diagnostic criteria for anteroseptal myocardial infarction include Q, QS, or QRS complexes in leads V1 through V4 along with evolving ST-T changes. In this example, leads V1 through V3 have large Q waves, while lead V4 has a large QS complex. All precordial leads contain ST-T wave elevations.