McGill Case 266

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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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This is the second EKG from a series of three. The first was taken at 99/8/[email protected] , the second below at 99/08/[email protected], and the third at 99/08/[email protected] The cardiogram is interesting as it shows evolution by comparison to that taken about 9 hours before. If one looks at the EKG recorded the following day there are further changes with deep T wave inversion in the anterior leads. In this case, in spite of the story of atypical chest pain and an initial cardiogram that the EKG machine interpreted as probable LVH with secondary repolarization changes, the patient evolved a non-Q MI. An angiogram showed a significant narrowing in the left anterior descending artery.