McGill Case 264

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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.

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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.