Evolving ST elevation and hyperacute T waves 1

Acute anterior STEMI with hyperacute T waves. ECG shows sinus at about 80 bpm with marked ST elevations in I, aVL, and VI to V5. ST depressions, consistent with reciprocal changes, are seen in leads II, III and aVF. Very slow R-wave progression is present in leads VI to V3. Markedly positive (hyperacute) T waves accompany the precordial ST elevations. Coronary angiography revealed a total proximal occlusion of the left anterior descending coronary artery, successfully treated with a percutaneous coronary intervention.