2.5 Anterior Myocardial Infarction on an ECG

Question 1

Explain what changes you would expect in an anterior MI.

Answer 1

ST elevations in V1-V6.

Note the attached image has very** large ST elevations (almost >10mm). These are the classical ‘tombstone’ ST elevations indicating **very severe MI.

OFF TO THE CATH LAB IMMEDIATELY!

Question 2

Where is this MI in the heart?

Name the key ECG findings.

Answer 2

The MI is mainly anterior, as noted by ST elevations in V1-V3, i.e. LAD.

However, there is also an element of ST elevation in aVF, that is, some lateral involement, i.e. LCX.

Notice that there are also Q waves (where the Q is greater than 1 little box) in VII, V3, aVL.

Question 3

Where is this MI?

Answer 3

There is ST elevation in V2-V5.

This is an anterior MI.