ECG of the Week - 20th August 2018 - Interpretation

This ECG is from a 71 yr old male who presented with chest pain for the last 90 minutes. He has a history of T2DM and hypertension.

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Rate:

• 104 bpm

Rhythm:

• Regular
• Sinus rhythm

Axis:

• Normal

Intervals:

• PR - Prolonged (~240ms)
• QRS - Normal (100ms)
• QT - 340ms

Additional:

• ST Elevation
• Leads I, II, III, aVF, V1-6
• ST Depression lead aVR
• Flat ST lead aVL with T wave inversion
• Hyperacture T waves leads II, III, aVF, V2-6

Interpretation:

• Extensive STEMI
• Anterior, high lateral and inferior
• Suggests "wrap around" LAD

What happened ?

The patient was transferred for urgent angiography, unfortunately I don't have the results of the cath.

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.