Electrocardiogram (ECG) is instrumental in identifying acutemyocardial infarction (AMI). ST segment elevation in a region of specificcoronary vessels in the setting of acute coronary syndrome (ACS) is the hallmark of AMI. Reciprocal ST depression and T wave inversion (TWI) are well-recognized changes that could accompany ST segment elevations. Reciprocal changes may represent the only early manifestation of AMI and may be present in specific leads such as lead aVL as early andsensitive markers of AMI. Abnormalities in ST segment and T wave can result from non ACS causes, but early recognition and appropriateintervention is of paramount importance for those patient with ACS. Wereport a case of a 55 year old male with acute IWMI with early reciprocaland dynamic ECG changes with literature review.
T wave inversion, MI and Reciprocal change