Anterior wall myocardial infarction - hyperacute phase
Hyperacute phase of anterior wall myocardial infarction – upsloping ST with tall T waves in V1-V4. This ECG was taken prior to thrombolytic therapy in the early phase of myocardial infarction.
Anterior wall myocardial infarction - post thrombolysis
This ECG was taken soon after thrombolysis and showed marked resolution of ST segment elevation, indicating successful thrombolysis with streptokinase. The T waves are still upright, but there is loss of R waves in V1-V3.
Anterior wall myocardial infarction - second day
ECG taken the next day showing QS complexes in V1-V3 with mild ST segment elevation. Left axis deviation, possibly due to left anterior hemi block and a late diastolic ventricular ectopic beat (11th beat in the rhythm strip) are seen. The ectopic occurs soon after the sinus P wave. The ectopic beat is similar to the normal one in V1 while it shows subtle differences in V2 and V3. This also demonstrates the advantage of simultaneous multi-channel recording in the evaluation of arrhythmias.
Anterior wall myocardial infarction - third day
ECG on third day shows a coved ST segment with T wave inversion in V2-V4 and QS complexes in V1-V2. T waves are inverted in inferior and lateral leads, indicating ischemia of inferior and lateral walls as well.