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Diagnosis of this ecg

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ACC AHA acute coronary syndrome guideline ST elevation ECG emergency evaluation

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This ECG is most consistent with an acute anterior ST-elevation myocardial infarction (anterior STEMI), likely from acute LAD coronary artery occlusion.
  • Sinus tachycardia, approximately 100-110 bpm
  • Marked ST-segment elevation with hyperacute T waves in V2-V5, most prominent V2-V4
  • Possible reciprocal ST depression in inferior leads
  • This is not a reassuring ECG pattern and should be treated as an emergency until proven otherwise.
If this ECG belongs to someone with chest pain, breathlessness, sweating, nausea, faintness, or new weakness, they need immediate emergency/cardiology assessment and reperfusion-capable care now. Do not wait for a repeat ECG or troponin result. The 2025 ACC/AHA acute coronary syndrome guideline directs triage based on ST elevation or a suspected equivalent.
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