In a two-stage review, electrocardiographic patterns associated with anterior infarction were determined in 135 patients whose diagnoses were established by contrast ventriculography. The five most common findings were tested in 1,324 consecutive patients to assess sensitivity, specificity, and predictive accuracies for anterior myocardial infarction. The criteria were shown to have high positive predictive accuracy and specificity levels, and confirmed the value of the standard 12-lead electrocardiogram for detecting anterior myocardial injury.