Wednesday, 7 October 2015

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