Concave ST elevation in V2-V5 with a notched J point and tall, slightly lopsided T waves, no reciprocal depression, and a V6 ST under a quarter of its T wave's height. A normal variant, mostly in the young.
A normal heart whose repolarization starts early. You see concave ST elevation, most in V2-V5, a little notch or slur at the J point (the fish hook, often best in V4), and tall T waves that rise slowly and fall a bit faster. There's no reciprocal ST depression. It gets smaller as the heart rate climbs and bigger as it slows. It's common in young men and rare past 50, so be very slow to call it in a symptomatic older patient. A straight or convex ST, any ST depression elsewhere, Q waves, or a QRS that has lost its S wave in V3 all argue for an anterior occlusion instead.
Each is a standard 12-lead: 2.5 seconds of each lead in four columns, with 10 seconds of lead II along the bottom, drawn to scale (25 mm a second, 10 mm a millivolt). The measurements are under each one.
Widespread, modest, concave ST elevation with PR depression, and the only ST depression in aVR (and V1), where the PR is elevated instead.
Broad, bulky T waves in V2-V4, big for the QRS in front of them, with a straightened ST and little or no ST elevation yet: the first minutes of an anterior occlusion.
ST elevation across V1-V4, from an occluded left anterior descending artery.
Sinus rhythm, a normal axis, normal intervals, R waves growing from V1 to V5, and no ST elevation or depression.
The ECG tool in the app gives you a new 12-lead every time and walks you through reading it: rate, QRS, axis, then where the ST is up and down. It's part of the Paramedic level, and you can try 5 ECGs a day free.
Try the 12-lead drill
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