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- 78 bpm
- Sinus arrhythmia
- PR - Normal (~180ms)
- QRS - Normal (80-100ms)
- QT - 380ms (QTc Bazette 435 ms)
- ST Elevation leads I & aVL (~1mm)
- ST Depression leads II, III, aVF, V4-5
- Prominent T wave lead V2
- High lateral STEMI
Patient was taken for urgent angiography which showed:
- Left main: Irregularity
- LAD: Diffuse disease 60% mid
- D1: 90% Mid
- LCx: 90% Proximal 70% Mid - PCI to LCx
- OM3: 70% Ostial
- RCA: Dominant 70% Ostial long 40-50% Mid
Post angio echo showed normal LV function and size with apico-lateral hypokinesis.
The patient made an uneventful post procedural recovery and will likely need further PCI to RCA & LAD.
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.