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Interpretation

Reading File
Now let me analyze the ECG image carefully.
Looking at this 12-lead ECG systematically:

ECG Interpretation

Rate

The rhythm strip (L2, bottom) shows a rate of approximately 75–85 bpm.

Rhythm

Regular — consistent R-R intervals throughout.

P Waves

P waves are visible and appear to precede each QRS complex, suggesting sinus rhythm.

PR Interval

Appears normal (~160–180 ms).

QRS Complex

  • Narrow QRS morphology — no bundle branch block
  • Pathological Q waves in L1, aVL, V1–V4: deep, wide Q waves visible in these leads

ST Segment / T Waves

  • ST elevation in V1–V4 with associated T-wave changes — this is the most striking finding
  • ST depression / reciprocal changes in L2, L3, aVF (inferior leads showing reciprocal depression)
  • T waves are inverted in V1–V4 and in aVL

Axis

  • Left axis deviation suggested by positive L1, negative L3

Primary Diagnosis

Anterior STEMI (ST-Elevation Myocardial Infarction)

Territory: Anterior/Anterolateral — LAD (Left Anterior Descending artery) occlusion
Supporting evidence:
FindingLeads
ST elevationV1–V4 (anterior territory)
Pathological Q wavesV1–V4 (established infarction / significant ischemia)
Reciprocal ST depressionL2, L3, aVF
T-wave inversionV1–V4, aVL
The presence of Q waves alongside ST elevation suggests this may be a completed or evolving MI (not hyperacute — Q waves indicate myocardial necrosis has already begun or is established).

Summary

ParameterFinding
Rate~80 bpm
RhythmNormal sinus rhythm
AxisLeft axis deviation
PR intervalNormal
QRSNarrow; pathological Q waves V1–V4
ST segmentsElevation V1–V4; depression II, III, aVF
T wavesInverted V1–V4, aVL
DiagnosisAnterior STEMI (LAD territory)
Immediate action required: This ECG warrants urgent cath lab activation for primary PCI. Administer antiplatelet therapy (aspirin + P2Y12 inhibitor), anticoagulation, and ensure continuous monitoring while arranging reperfusion.
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