Decoding a Dangerous ECG Pattern

A 57-year-old man presents with Chest Pain. His ECG shows widespread ST depressions and elevation in aVR. What does this critical pattern signify?

Diffuse subendocardial ischemia


A 57-year-old man called emergency medical services to report a 1-hour history of chest pain. When he arrived at the hospital, his heart rate was 125 beats per minute, the blood pressure 128/84 mm Hg, and the oxygen saturation 99% while he was breathing ambient air. The physical examination was normal. An initial serum troponin I level was 35 ng per liter (reference range, 0 to 34). What does the electrocardiogram most likely represent?

What is the most likely diagnosis?

Anteroseptal ST-elevation myocardial infarction
Diffuse subendocardial ischemia
Pericarditis
Posterior myocardial infarction
Wellens syndrome

Chest Pain, Diffuse subendocardial ischemia, Electrocardiogram, Left Main Coronary Artery Disease, NSTEMI

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