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Minimal or no cardiac biomarker elevation.Concerning for proximal critical high grad LAD occlusion.Left Main Coronary Artery Occlusion will have the same findings as above but patients will be in cardiogenic shock if not coding.In one study STD in leads I, II, and V4 – V6 + STE in aVR present in 90% of patients with greater than 70% stenosis of the LMCA.Images From: LITFL Blog Left Main Coronary Artery Stenosis Tall, Symmetric T-Wave in leads V1 – V4.Upsloping ST-Depression at J Point in leads V1 – V4 without STE.Concerning for proximal LAD occlusion (Present in 2% of patients).STE in aVL and V2 + lack of STE in other precordial leads = 89% PPV for MI of the anterior wall caused by a D1 lesion.ST-Depression and inverted T waves in Inferior Leads (III and aVF).
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