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Vol. 72. Issue 2.
Pages 165 (February 2019)
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Vol. 72. Issue 2.
Pages 165 (February 2019)
ECG Contest
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ECG, February 2019
ECG de febrero de 2019
Alejandro Cruz-Utrilla
Corresponding author

Corresponding author:
, Hernán Mejía-Rentería, Alejandro Travieso-González
Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain
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Rev Esp Cardiol. 2019;72:24810.1016/j.rec.2018.04.033
Alejandro Cruz-Utrilla, Hernán Mejía-Rentería, Alejandro Travieso-González
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A 50-year-old man with a history of hypertension contacted the out-of-hospital emergency service after onset of oppressive retrosternal chest pain with radiation to the left arm and sweating. The first ECG recorded on arrival in the emergency room is the one shown in the Figure.


According to this ECG, what was the most likely diagnosis?

  • 1.

    Non–ST-elevation acute coronary syndrome (NSTE-ACS), with an ECG indicative of left main coronary artery involvement or 3-vessel disease.

  • 2.

    NSTE-ACS but the affected vessel cannot be identified.

  • 3.

    Posterior ST-elevation acute coronary syndrome (STE-ACS), with an ECG indicative of involvement of a posterolateral branch.

  • 4.

    Anterior STE-ACS, with an ECG indicative of ostial-proximal left anterior descending artery involvement.

Submit your answer to The solution will be published in the next issue (March 2019). #ECGChallenge #RetoECG.

Copyright © 2018. Sociedad Española de Cardiología
Revista Española de Cardiología (English Edition)

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