![]() When present, findings of ST-elevations greater than 2 mm in two contiguous leads on ECG (inferior: leads II, III, aVF septal equal V1, V2 anterior: V3, V4 lateral: I, aVL, V5, V6) are indicative of an ST-elevation myocardial infarction. ![]() For example, peaked T-waves on ECG, known as “hyperacute T waves,” often indicate early ischemia and will progress to ST elevation. Right-sided, posterior lead placement, and repeat ECG testing can increase ECG sensitivity. The ECG is highly specific for MI (95% to 97%), yet not sensitive (approximately 30%). All of these presentations should prompt ECG testing, as well. Elderly patients more often have shortness of breath as their presenting symptom for myocardial infarction. ![]() Women often have atypical symptoms such as abdominal pain or dizziness and may present without chest pain at all. ![]() Early and rapid ECG testing should be employed in all patients presenting with chest pain.
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