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Answer for Sept. 13, 2013

here are no clear r waves in leads V1 and V2, and a small r wave in lead V3. As a result, the complexes are likely QS complexes. Confirming the impression that these are pathologic Q waves, the ST segments remain mildly elevated in V1 and V2, with T wave inversions visible until V6. This pattern suggests a relatively recent (hours to days) SEPTAL MI (STEMI). There may be residual ischemia acoss the precordium.

The V leads are regional so that V1 and V2 are called 'septal', V3-V5 are anterior, and V6 is called 'apical'. Of course, this is by convention, and there is considerable anatomic overlap. Remember that V1 and V2 also reflect the posterior wall, with an 'opposite and upside down' polarity: ST elevations posteriorly are ST depressions anteriorly, and Q waves posteriorly are R waves anteriorly.

NOTE: EKG's are for internal educational purposes of the University of Massachusetts Department of Family Medicine. Please do not forward without permission from Dr. Golding!

Sept. 13 EKG