ACS Series

54 year old female with chest pain for 3 days. Trop I 0.34 on day 3rd. Below is the ECG. diagnosis?

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There is significant ST segment depression with T wave inversion in lead II, III and aVF along with leads I, aVL V4 - V6 There is ST segment depression with upright T wave in lead V2 and V3 This is suggestive of inferolateral wall Ischaemia With possibility of a non-ST segment elevation myocardial infarction (NSTEMI) Please do cardiac enzymes, 2 D ECHO and plan for urgent Angiography SOS angioplasty

Classic Left Main disease higher possibility , possible aslo tripple vessel disease : characteristic of both ST segement elevation in lead aVR and ST depression in rest of the leads . Cousel patient for Coronary angiography , and sos intervention

Sinus tachycardia. St depression in all leads.it is ACS. May t upright in avr .sub endocardial infarction. Needs thrombolysis/ coronary intervention. 2d echo is advised

NSR ,sinus tachycardia Significant ST depression in anterior and lateral leads with ST elevation in avR ? Left main branch Occlusion Urgent Angio

ACUTE CORONARY SYNDROME ST-T DEPRESSION IN ALL LEADS AND ELEVATION IN AVR V1 TROP I IS INSIGNIFICANT INFEROLATERAL ISCHIMIA

ST depression with t wave inversion In V2 to V6 and 2,3,avf.Trop T is positive all indication of ACS

Globally St segment depression with st segment elevation in lead AVR > V1. possibly LMCA occlusion