Which of the following is a medical positive finding (status 2)?

• A. ST elevations in multiple leads only
• B. Chest pain with ECG normal
• C. ST elevations in a single contiguous lead
• D. STEMI - chest pain plus ST elevation in at least 2 contiguous leads

Answer: (D)

This item is testing how STEMI is identified in the field: you determine a STEMI when there is clear ischemic chest pain plus objective ECG evidence. For a diagnosis of STEMI, the ECG must show ST-segment elevation in at least two contiguous leads, which reflects transmural ischemia in a specific area of the heart. Two contiguous leads confirm that the injury is localized rather than a diffuse or non-ischemic pattern.

Chest pain alone isn’t enough, and ST elevations in just a single lead aren’t sufficient either. ST elevations across many noncontiguous leads without the Chest pain criterion wouldn’t meet the STEMI criteria in this status workflow. Therefore, the best option is the one that pairs chest pain with ST elevation in at least two contiguous leads, matching the standard STEMI definition and triggering the status for urgent transport and cath lab activation.