This ECG demonstrates two of these three criteria. It is from a 91 year old man who presented with chest pain, elevated cardiac enzymes and left bundle branch block. Note the marked ST elevation in leads V1-V5. It is directed opposite to the QRS complex (is discordant to the QRS complex) in leads V1-3 with a maximal elevation of 7 mm in lead V3 (criterion #3). In leads V4 and V5, there is less ST elevation but it is concordant with the QRS complex (criterion #1). The second criterion, ST segment depression equal to or greater than 1mm in leads V1, V2 or V3, is not present.