This ECG shows signs of an acute antero-septal myocardial infarction in a 49-year old man presenting with chest pain, requiring urgent therapy. The ECG reveals normal sinus rhythm, a normal QRS axis and duration, and marked ST elevation in leads V1-V4, consistent with an antero-septal injury pattern diagnostic of an acute antero-septal infarction.

1. Stepwise interpretation of ECG ID 594a Acute antero-septal infarction

2. ID 594a 49 year old man in the Emergency Dept. with severe anterior chest pain of 1 hour duration Obviously this ECG shows an antero-septal injury pattern of acute myocardial infarction, requiring urgent therapy . We will go through a quick step-wise diagnostic process.

3. ID 594a - Normal sinus rhythm, 84/min. Regular sinus-node P waves are present, rate 84/min., followed by QRS complexes The PR interval is normal. There are no signs of right or left atrial enlargement.

4. ID 594a - Normal sinus rhythm, 84/min. The QRS axis is normal (+60 degrees) – The QRS duration is normal (90 msec.) -

5. ID 594a Final diagnosis: Normal sinus rhythm, 84/min. Antero-septal injury pattern ( Acute antero-septal infarction) No signs of ventricular hypertrophy. No QRS changes of infarction. There is marked ST elevation in V1-V4: injury pattern, in keeping with acute antero-septal infarction