Diagnosis and Treatment of a Case of STEMI Without Typical Acute-Phase ECG Changes
Abstract：Acute ST-segment elevation myocardial infarction (STEMI) is a severe acute coronary syndrome caused by the acute occlusion of a coronary artery. The electrocardiogram (ECG) typically shows a series of characteristic abnormal changes, mainly including tall, symmetric T waves and ST-segment elevation [1,2]. The earliest changes usually appear in the leads corresponding to the site of myocardial infarction, characterized by tall, symmetric T waves, resembling "tall T waves," reflecting repolarization abnormalities due to local myocardial ischemia [3]. Subsequently, ST-segment elevation occurs, presenting as a convex upward shape, most commonly seen in the leads related to the site of myocardial infarction. ST-segment depression is often observed in the opposite leads, representing the mirror image effect of the myocardial infarction leads. Pathological Q waves may appear early and/or late in the process, further supporting the diagnosis of STEMI [4]. After coronary artery occlusion, ECG changes typically occur within minutes to hours of myocardial ischemia. Emergency physicians should pay attention to the ECG findings during the evolution of STEMI and fully understand their pathophysiology and clinical significance [5].
Machine-generated Keywords：
Publication Date：2025-06-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 746-747,750 )