A unique “non-STEMI” pattern of acute proximal LAD occlusion

I just ran across this via a post at Dr. Smith's blog. In 2% of acute LAD occlusions in a large database the authors observed, in the indicative precordial leads, upsloping ST segment (J point) depression leading into the more typical broad based high amplitude hyperacute T waves. The ST depression was static---it didn't evolve into the more typical ST elevations. It was a little noticed letter to the editor of the NEJM by a major league group. Free full text access allows viewing of eight of these fascinating tracings.