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Inferior wall myocardial infarction (IWMI) is conventionally described to present with ST segment elevation in leads II, III and aVF. Isolated elevation of the ST segment in one or two leads may be confusing and sometimes non-diagnostic. 1 2 The occurrence of such patterns in patients presenting with chest pain may confuse the primary care physicians and may lead to inappropriate delay in management of the infarction.
We report an interesting ECG pattern in a 49-year-old male patient who presented to our institute with acute onset of severe chest pain since 3 h. The patient was a known case of systemic hypertension since the past 5 years and was a chronic smoker. The ECG showed ST segment elevation in lead III, aVF, but there was ST segment depression in lead II and the lateral precordial leads which is very unusual in a case of IWMI ( figure 1 ). The patient was taken up for primary angioplasty. The diagnostic coronary...