This post is an answer to the ECG Case 293
- Rate: 54 bpm
- Rhythm:
- Regular
- 2:1 AV block
- Axis: Normal
- Intervals:
- QRS – Normal (100ms)
- QT – 320 ms
- Segments:
- ST Elevation in leads II (1mm), III (2mm), aVF (1mm)
- ST Depression in leads I, aVL, V 1-5
- Additional:
- Prominent T wave in leads V2-3
- Pathological Q waves in III and aVF
Interpretation
- Inferoposterior OMI
- 2:1 AV Block
What happened next ?
The patient was taken for urgent angiography, which showed:
- Right dominant system
- Left main: Normal
- LAD: Mild mid-stenosis
- Cx: Normal
- RCA: 70% Proximal stenosis, 100% mid-stenosis, 70% distal stenosis
3 x Drug-eluting stents were place in across the RCA lesions. The patient made an uneventful recovery following angiography and reverted to sinus rhythm 48 hours post stenting.
READ MORE: ECG Interpretation – All you need to know
