An emergency ECG sign of ST elevation myocardial infarction

The occlusion of the left anterior descending coronary artery (LAD) is usually characterized by the ST-segment elevation associated with a tall and peaked T wave in precordial leads. We reported a case who suffered from typical chest pain and tall and positively symmetrical T waves in leads V2–6, J point depression with upsloping ST-segment depression. However, the coronary angiogram demonstrated a 100% occlusion of midshaft LAD artery. Recognition of this atypical electrocardiogram (ECG) pattern can ensure immediate reperfusion therapy regarding acute myocardial infarction.