ECG of the Week - 9th January 2017 - Interpretation

This ECG is from a 59 yr old male who presented with episodic chest pain for the last 2 weeks which had been constant for the last 1 hour. He has a past medical history of hypertension.

 

 

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Rate:

• ~125 bpm

Rhythm:

• Regular
• Sinus Rhythm

Axis:

• Normal

Intervals:

• PR - Normal (~180ms)
• QRS - Normal (60ms)

Segments:

• ST Elevation leads: I (0.5-1mm), aVL (1mm), V1 (1mm), V2 (8-9mm), V3 (4mm), V4 (1mm)
• ST Depression leads: II, III, aVF, V5-6

Interpretation:

• Anterior STEMI

 What happened ?

The patient was transferred for urgent angio which showed:

• Left main 40% ostial lesion
• LAD diffuse disease with severe mid disease and severe distal disease - PCI with DES x 2
• Cx severe ostial
• RCA Diffuse mild-mod disease

Post procedure echo:

• Mod-severe segmental dysfunction with extensive anterior wall akinesis - EF 37%
• No significant valvular dysfunction

The patient had an uneventful further in-patient stay.

References / Further Reading

 

Life in the Fast Lane

• Anterior STEMI

Textbook

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