|Click to enlarge|
- 120 bpm
- Regularly irregular
- Alternating sinus complex and PVC
- Sinus complex - normal axis
- PVC - extreme axis
- PR - Normal (~200ms)
- QRS - Normal (100ms)
- QT - 480ms
- QRS - Prolonged (120ms)
- ST Elevation leads V2 (2mm) V3 (3mm) V4 (2mm) V5 (2mm) V6 (1mm)
- T inversion lead aVL
- Hyperacute T waves leads V2-4
- Excessive discordant ST elevation in the PVC's leads V2-6 - see edited ECG'sbelow
- Antero-lateral STEMI
What happened ?
The patient was taken for urgent angiography and PCI and has a mid-LAD lesion stented.
Whilst the key features on this ECG and reasonably apparent the presence of frequent PVC can distract the eye and male interpretation difficult. I've edits the ECG below to show only the sinus complexes.
|ECG with only sinus complexes shown|
|ECG with only PVC's shown|
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.