Evidence mapPaperPMID 41025839Full record

ArticleThe Permanente journal2025

Electrocardiogram Diagnosis: ST-Depression With T Wave Inversion in Lead Augmented Vector Left as Harbinger of Inferior ST-Elevation Myocardial Infarction.

Grace V Heringer, Cole J Florio, Aidan R Campbell, David R Vinson, Joel T Levis

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Article in The Permanente journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Grace V HeringerKaiser Permanente Clinical Research on Emergency Services & Treatments (CREST) Network, Pleasanton, CA, USA.ORCID 0009-0002-1610-3314
Cole J FlorioKaiser Permanente Clinical Research on Emergency Services & Treatments (CREST) Network, Pleasanton, CA, USA.ORCID 0009-0003-5277-6433
Aidan R CampbellKaiser Permanente Clinical Research on Emergency Services & Treatments (CREST) Network, Pleasanton, CA, USA.ORCID 0000-0003-4475-2629
David R VinsonKaiser Permanente Clinical Research on Emergency Services & Treatments (CREST) Network, Pleasanton, CA, USA.ORCID 0000-0001-6559-1858
Joel T LevisThe Permanente Medical Group, Pleasanton, CA, USA.ORCID 0000-0001-8174-3161

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A 53-year-old male presented to the emergency department (ED) after waking up with retrosternal chest discomfort. An initial prehospital 12-lead electrocardiogram (ECG) obtained by emergency medical services indicated sinus rhythm with ST-segment depression and T wave inversion in lead augmented vector left (aVL) but without significant ST-segment elevations. Upon ED arrival, a repeat ECG demonstrated minimal ST-segment elevation in the inferior leads, raising concern for an evolving inferior ST-segment elevation myocardial infarction (STEMI) and prompting cardiac catheterization laboratory activation. A repeat ECG obtained 18 minutes after the initial ED ECG confirmed acute inferior STEMI. Coronary angiography revealed 70% ulcerated stenosis in the mid right coronary artery (RCA) and 100% thrombotic occlusion of the distal RCA. Successful percutaneous coronary intervention to the occluded RCA was undertaken with restoration of Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow. The patient was discharged on hospital day 3. This case underscores the significance of reciprocal changes in lead aVL as an early marker of inferior STEMI, as well as the importance of serial ECGs and timely intervention to optimize patient outcomes in acute coronary syndrome.

Indexed as

ElectrocardiographyST Elevation Myocardial InfarctionCoronary AngiographyHumansMaleMiddle AgedPercutaneous Coronary Interventionacute coronary syndromeearly diagnosiselectrocardiographyinferior wall myocardial infarction

Identifiers

PMID41025839
PMCPMC12703537

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.