Wednesday, 19 March 2014

ECG of the Week - 17th March 2014 - Interpretation

This is one of the older ECG's in my collection. I don't have any clinical information but it's safe to say the patient complained of chest pain.
Check out the comments on our original post here.


Click to enlarge
Rate:
  • 84
Rhythm:
  • Regular
    • Likely sinus 
    • Baseline artefact
Axis:
  • Normal
Intervals:
  • QRS - Normal (100ms)
  • QT - 320ms (QTc Bazette 380 ms)
Segments:

  • ST Elevation 
    • Leads I (1.5mm), aVL (2mm), V1(1mm), V2 (6mm), V3 (5mm), V4 (5mm), V5 (2mm)
  • ST Depression leads II, III, aVF

Additional:

  • T wave inversion leads III, aVF
  • Q wave leads V1-2

Interpretation:

  • Antero-lateral STEMI


This patient underwent thrombolysis acutely as per local policy at the time. I don't have any further clinical information on the case unfortunately.

Thrombolysis

I just thought I briefly touch on contraindications for thrombolysis in STEMI as I'm currently reading for the FACEM exam and it comes up occasionally. 
The following list is taken from the Australian Resuscitation Council Guideline 14.3 'Acute Coronary Syndromes: Reperfusion Strategy'.


Contraindications to thrombolysis in STEMI
ARC Guideline 14.3
Click to enlarge

References / Further Reading

Life in the Fast Lane

  • Anterior STEMI here
  • Lateral STEMI here
Textbook
  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.