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.

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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

• Inferior STEMI 

Textbook

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