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Patient
57-year-old man, obese, smoker, hospitalized for constrictive chest pain since 5 hours;
Trace
Sinus rhythm, normal PR interval; Q-waves from V2 to V6 with high amplitude elevation from V2 to V5 and tall and peaked T-wave (upward slope less steep than the downward slope); depression in lead III with negative T-waves in leads III and aVF;
Trace
Emergency coronary angiography was performed with evidence of an occlusion of the mid-LAD. This ECG was recorded after angioplasty with stent placement; the Q-waves are enlarged with fragmentation and QS pattern in V3; regression of the elevation and sharp decrease in the amplitude of the T-waves;
Trace
Tracing recorded at day 3; appearance of a negative, symmetrical and deep T-wave in the leads initially presenting the elevation;
Exergue
It is common to describe a "stereotyped" sequence of electrical modifications during an acute coronary syndrome. Certain phases may be missing, fleeting or delayed. The initial modifications of the T-wave are often unrecorded for example, the first tracing being too late.
The tracings of this patient show the evolution of the electrical changes observed during an acute coronary syndrome with, in chronological order, the onset, apogee and regression of abnormalities of the QRS-complex, the ST-segment and the T-wave.