An ECG monitoring system for identifying a culprit coronary artery associated with an acute myocardial infarction comprising: a set of electrodes adapted for acquisition of electrical activity of the heart from different vantage points in relation to the heart; an ECG acquisition module coupled to the electrodes which act to produce enhanced electrode signals; an ECG processor responsive to the electrode signals which acts to combine electrode signals for the production of a plurality of lead signals measuring electrical activity of the heart from different vantage points, wherein the ECG processor detects ST elevation in lead signals; and a display responsive to detected ST elevation which displays ST elevation data graphically in relation to anatomical lead locations, characterized in that the graphical display enables identification of the identity of a suspect culprit coronary artery or branch associated with an acute ischemic event by displaying a chest graphic and a limb lead graphic, and the ECG processor is responsive to a plurality of chest electrode signals for the production of ST elevation data and use of the data for the production of the chest graphic oriented horizontally with respect to the anatomy of a subject, wherein the chest graphic is indicative of one or more of LCx, RCA, and LAD coronary artery occlusion, and the chest graphic further comprises a shape delineated by ST elevation data values; and the locations of the LCx, RCA, and LAD coronary artery occlusion are shown by circled letters the ECG processor is responsive to a plurality of limb electrode signals for the production of ST elevation data and use of the data for the production of the limb lead graphic oriented vertically with respect to the anatomy of a subject, wherein the limb lead graphic is indicative of one or more of LCx, RCA, and LAD coronary artery occlusion, and the limb lead graphic further comprises a shape delineated by ST elevation data values; and the locations of the LCx, RCA, and LAD coronary artery occlusion are shown by circled letters. a set of electrodes adapted for acquisition of electrical activity of the heart from different vantage points in relation to the heart; an ECG acquisition module coupled to the electrodes which act to produce enhanced electrode signals; an ECG processor responsive to the electrode signals which acts to combine electrode signals for the production of a plurality of lead signals measuring electrical activity of the heart from different vantage points, wherein the ECG processor detects ST elevation in lead signals; and a display responsive to detected ST elevation which displays ST elevation data graphically in relation to anatomical lead locations, characterized in that the graphical display enables identification of the identity of a suspect culprit coronary artery or branch associated with an acute ischemic event by displaying a chest graphic and a limb lead graphic, and the ECG processor is responsive to a plurality of chest electrode signals for the production of ST elevation data and use of the data for the production of the chest graphic oriented horizontally with respect to the anatomy of a subject, wherein the chest graphic is indicative of one or more of LCx, RCA, and LAD coronary artery occlusion, and the chest graphic further comprises a shape delineated by ST elevation data values; and the locations of the LCx, RCA, and LAD coronary artery occlusion are shown by circled letters the ECG processor is responsive to a plurality of limb electrode signals for the production of ST elevation data and use of the data for the production of the limb lead graphic oriented vertically with respect to the anatomy of a subject, wherein the limb lead graphic is indicative of one or more of LCx, RCA, and LAD coronary artery occlusion, and the limb lead graphic further comprises a shape delineated by ST elevation data values; and the locations of the LCx, RCA, and LAD coronary artery occlusion are shown by circled letters.