Wednesday, 20 September 2017

ECG of the Week - 18th September 2017 - Interpretation

This ECG is from a 52 yr old male who presented with 14 hours of chest pain.



Click to enlarge

Rate:
  • 102 bpm
Rhythm:
  • Regular
  • Sinus rhythm
Axis:
  • LAD
Intervals:
  • PR - Normal
  • QRS - Normal
  • QT - 330ms (QTc Bazette 430 ms)
Additional:
  • ST elevation lead II (1mm), aVF (1mm)
  • ST depression leads I, aVL, V2-5
Interpretation:
  • Inferior STEMI
What happened ?

Following urgent liaison with cardiology the patient was taken for urgent angiography which showed:
  • Left main: Normal
  • LAD: 30% Mid lesion
  • Cx: 100% Mid lesion - dilated and stented
  • RCA: 30% Mid lesion
Post PCI echo showed inferior and infero-lateral wall motion abnormality with preserved systolic function.
The patient was commenced on dual anti-platelet therapy (DAPT), ACE inhibitor, beta-blocker and statin and discharged following a brief 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.