Novedades en el electrocardiograma de los síndromes coronarios agudos. De los patrones conocidos a las manifestaciones inusuales

Within the context of an acute coronary syndrome (ACS), the electrocardiogram (ECG), provides proper classification and risk stratification. Early ECG changes detection is crucial in diagnosing acute complete coronary obstruction. Persistent ST segment elevation is usually the clue for urgent reperfusion. Nevertheless, there are situations where even in presence of coronary occlusion we can not find the expected ST segment elevation. Furthermore, there are unusual ECG patterns related with significant risk. To recognise these situations is a real challenge for care providers.