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INTRODUCTION

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The electrocardiograms (ECGs) in this atlas supplement those illustrated in Chap. 268. The interpretations emphasize findings of specific teaching value.

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All of the figures are from ECG Wave-Maven, Copyright 2003, Beth Israel Deaconess Medical Center, http://ecg.bidmc.harvard.edu.

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The abbreviations used in this chapter are as follows:

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  • AF—atrial fibrillation

  • HCM—hypertrophic cardiomyopathy

  • LBBB—left bundle branch block

    LVH—left ventricular hypertrophy

  • MI—myocardial infarction

  • RBBB—right bundle branch block

  • RV—right ventricular

  • RVH—right ventricular hypertrophy

  • SR—sinus rhythm

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MYOCARDIAL ISCHEMIA AND INFARCTION

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FIGURE 269e-1

Anterior wall ischemia (deep T-wave inversions and ST-segment depressions in I, aVL, V3–V6) in a patient with LVH (increased voltage in V2–V5).

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FIGURE 269e-2

Acute anterolateral wall ischemia with ST elevations in V4–V6. Probable prior inferior MI with Q waves in leads II, III, and aVF.

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FIGURE 269e-3

Acute lateral ischemia with ST elevations in I and aVL with probable reciprocal ST depressions inferiorly (II, III, and aVF). Ischemic ST depressions also in V3 and V4. Left atrial abnormality.

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FIGURE 269e-4

Sinus tachycardia. Marked ischemic ST-segment elevations in inferior limb leads (II, III, aVF) and laterally (V6) suggestive of acute inferolateral MI, and prominent ST-segment depressions with upright T waves in V1–V4 are consistent with associated acute posterior MI.

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FIGURE 269e-5

Acute, extensive anterior MI with marked ST elevations in I, aVL, V1–V6 and low amplitude pathologic Q waves in V3–V6. Marked reciprocal ST-segment depressions in III and aVF.

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FIGURE 269e-6

Acute anterior wall MI with ST elevations and Q waves in V1–V4 and aVL and reciprocal inferior ST depressions.

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FIGURE 269e-7

SR with premature atrial complexes. RBBB; pathologic Q waves and ST elevation due to acute anterior/septal MI in V1–V3.

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FIGURE 269e-8

Acute anteroseptal MI (Q waves and ST elevations in V1–V4) with RBBB (note terminal R waves in V1).

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FIGURE 269e-9

Extensive prior MI involving inferior-posterior-lateral wall (Q waves in leads II, III, aVF, tall R waves in V1, V2...

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