When you think of acute left main
coronary syndrome the electrocardiographic picture that probably
comes to mind is that of multi-lead ST depression with elevation in
aVR. At least that's what I tend to think and have blogged the
concept many times. It's true but it's not the whole story. It
applies to left main ischemia but what about occlusion or near total
occlusion of the left main? Well, that's a different pattern
altogether and not often seen. How many of those folks make it to
the hospital, after all? It's a unique and frightening combination
of electrocardiographic features with a few variations an the theme.
Here's a post at EMS 12 Lead with some examples and links.
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