Your patient says, Doc, I have crushing chest pain. We get an EKG. Let’s learn to read it like a cardiologist. β€ŠWhat abnormality do you see?

There are ST elevations in II, III, and AVF, with reciprocal ST depressions in I and AVL. Our patient has an inferior STEMI.

But which coronary artery is occluded? For 80 percent of people, the inferior part of the heart is fed by the right coronary artery, while for 20 percent of people, it’s the left circumflex.

Our EKG can give us hints depending on the degree of ST elevation in leads II and III. If the ST elevation is more in lead III than in lead II, then it’s most likely that our patient had an occlusion of the right coronary artery.

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What’s the diagnosis?

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