Do you know any STEMI equivalent condition where there is no actuall ST elevation ?

Those who work in state of art cath labs as well ER probably familiar with this scenerio.

:de Winter ECG pattern is a STEMI equivalent that presents without obvious ST segment elevation.

Upsloping ST depression and peaked T waves in the precordial leads(V2-V6) and some times in I and II.

The de Winter pattern is an indication of Proximal LAD blockage and highly Underreported among clinicians( May be because it's relatively new and lack of expertise in EKG interpretation)

Don't delay in sending the patient directly to cath lab because it leads to catastrophic situation if you fail to send the pt for PCI .

Below is a good example of De winter t wave pattern .
Courtsey: Google Images