Differential Diagnosis for Elevation in Leads V1, V2, V3 with Flipped T Waves in Leads 2,3, AVF, V4, V5, V6
- Single Most Likely Diagnosis
- Acute Anterior Myocardial Infarction (MI): The elevation in leads V1, V2, V3 is indicative of an anterior wall MI. The flipped T waves in the other leads suggest ischemia or infarction in a broader area of the heart, which can occur in the setting of an acute MI, especially if it involves the left anterior descending artery.
- Other Likely Diagnoses
- Acute Coronary Syndrome (ACS): This includes unstable angina and non-ST elevation MI, which can present with similar ECG changes, although the ST elevation in leads V1-V3 is more specific for an ST-elevation MI.
- Pericarditis: While pericarditis typically causes more widespread ST elevation, some cases can present with localized ST elevation and T wave inversion, especially if there is associated myocardial involvement.
- Do Not Miss Diagnoses
- Pulmonary Embolism (PE): Although less common, a large PE can cause ECG changes including T wave inversion in the anterior leads and can be life-threatening if not promptly diagnosed and treated.
- Aortic Dissection: This condition can cause chest pain and ECG changes due to involvement of the coronary arteries or direct injury to the heart. It is critical to consider this diagnosis due to its high mortality rate if not promptly treated.
- Rare Diagnoses
- Hypertrophic Cardiomyopathy: This condition can cause abnormal ECG findings including ST elevation and T wave inversion, but it would not typically cause acute changes unless there was an acute event such as a myocardial bridging or outflow tract obstruction.
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): This rare condition can cause ECG abnormalities including T wave inversion in the anterior leads, but it is less likely to cause the pattern of ST elevation seen in this scenario.
- Early Repolarization Syndrome: This benign condition can cause ST elevation but typically does not cause flipped T waves in multiple leads, and the clinical context would not suggest an acute cardiac event.