LMCA occlusion: High incidence of cardiogenic shock, need immediate PCI +/- CABG, not tPA.
LAD-D1 occlusion pattern:
1. High lateral STEMI (South Africa flag sign).
2. Highly predictive (89% PPV) of anterior wall MI.
High Lateral STEMI (South Africa Flag Sign)
Posterior wall MI: True STEMI, can be easily missed if isolated (ECG #3). May get leads V7,8,9 for confirmation. Inferior wall STEMI also noted in ECG #1 and #2.
Wellens' syndrome: Subacute critical occlusion of proximal LAD or mid-LAD. Avoid excercise stress test.
De Winter's T: Anterior STEMI equivalent due to acute proximal LAD occlusion.