ECG of the Week - 5th October 2015 - Interpretation

This week's ECG is from a 75 yr old male who presented with 1 hour of central chest pain.

Click to enlarge

Rate:

• 51 bpm

Rhythm:

• Regular

Axis:

• LAD

Intervals:

• PR - Normal (180ms)
• QRS - Normal (100ms)

Segments:

• ST Elevation leads I (2mm), aVL (3mm), V1, (1.5mm),V2 (2mm)
• ST Depression leads II, III, aVF, V4-6

 

Additional:

• T wave inversion II, III, aVF, V5-6

 

Interpretation:

• Antero- high lateral STEMI

 

What happened ?

The patient for taken for urgent angiogram which showed:

• 100 % Occlusion of the 1st diagonal branch --> Stented
• 40% stenosis mid LAD
• 50% stenosis distal LAD
• 70% stenosis distal CX
• 100%stenosis OM4

Echo showed apical anterior and anterolateral akinesis with normal systolic function.
The patient made an uneventful recovery and was discharge after 2 days.

References / Further Reading

 

Life in the Fast Lane

 

• High lateral STEMI
• Lateral STEMI

Textbook

 

 

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