STAT ECG Diagnoses: how to identify acute coronary occlusion myocardial infarction in patients with left ventricular hypertrophy (LVH) with strain

ECG Weekly Workout with Dr. Amal Mattu


A 60-year-old man presents to the emergency department with central chest pain for the last 2.5 hours concerning for cardiac ischemia.  The following ECG is obtained on arrival:

Before watching the video, look closely at this ECG and ask yourself:

  1. What ECG abnormalities do you notice?
  2. Are there any findings on this ECG that predict ACS?
  3. How can we accurately diagnose STEMI in patients with LVH with strain pattern?