ACLS Revision: Subtle ECG findings in ACS

ST-segment elevation in lead aVR portends a worse prognosis in ACS and often predicts the need for CABG.
Hyperacute T-waves are not necessarily tall, and small T-waves can still be hyperacute when paired with a low-amplitude QRS complex.
The tall T-waves associated with hyperkalemia are sharp, pointy, symmetric, and have a narrow base.
When in doubt, get serial ECGs (every 15 minutes) and use adjunctive information.

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