This is the first of six ECGs donated to the ECG Guru by our friend, Jenda Enis Štros.
The patient is a man in his 60's with chest pain. This is a pre-hospital ECG showing ST elevation across the anterior wall, beginning in V2. Though the upwardly-concave shape "smile" appears rather benign, the amount of j-point elevation in these five related leads - in a man with chest pain - does not favor a diagnosis of early repolarization. The diagnosis is STEMI, and the cath lab is activated.
Links to the entire series of six ECGs: