Wednesday, 11 January 2017

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.

 
 
Click to enlarge


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