Concerning chest pain with ST segment depression in the anteroseptal leads (Part 1/2)

Emergency Cardiology Literature Review & Updates with Dr. Amal Mattu


A 72-year-old woman with a past medical history of diabetes, coronary artery disease, and heart failure presents to the emergency department with acute onset chest and back pain.  Pain is described as severe, associated with vomiting and diaphoresis, and is slightly improved with prehospital nitroglycerin. The following ECG is obtained:

Before watching the video, ask yourself:

    1. What is your differential for ST depression in the anteroseptal leads?
    2. Is this ECG suggestive of occlusion MI that necessitates emergent cath?