McGill Case 264

This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia. Previous Case: McGill Case 263 | Next Case: McGill Case 265

The cardiogram shows sinus bradycardia at 47/min. and a poor r wave progression in the anterior chest leads with Q waves in leads V2 to V4 which are diagnostic of anterior myocardial infarction. Note that unlike the normal septal Q waves that start later in the progression of the chest leads and at the same time grow larger, the Q waves in this patient are abnormal because they are present in leads V2, V3, and V4 and are larger than those in V5 and V6. The cardiogream also shows abnormal T wave inversion and slicht ST ellivation in leads V1 to V3.