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Figure 1 Serial changes are depicted between the prehospital (left) and initial hospital (right) ECG in a patient with chest pain. The prehospital ECG depicts acute ST segment elevation in leads I, aVL and V4 to V6. On the initial hospital ECG, obtained 35 min after the prehospital tracing, ST segment elevation is more difficult to appreciate in leads I and aVL and deceptively masquerades as an apparent widening of the QRS complex in leads V4 to V6.
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