ECG Interpretation
- Sinus rhythm, rate 111/min
- Normal axis
- Probably normal QRS complexes
- Gross elevation of ST segments in anterior and lateral leads (“Tombstone” ST Segment Elevation)
- Reciprocal ST segment depression in the inferior leads (II, III, aVF)
Clinical interpretation
Acute ST segment elevation anterolateral myocardial infarction (STEMI). In the lateral leads I, VL and V4–V6, it is difficult to see where the QRS complexes end and the ST segments begin, but in lead II it is clear that the QRS complex is of normal width.
What to do ?
If the patient gives a history suggestive of a myocardial infarction and has this ECG, no further investigations are needed in the acute phase of the illness, and in particular there is no place for a chest X-ray.
Routine treatment for a myocardial infarction – pain relief, aspirin and percutaneous coronary intervention (PCI) or thrombolysis – should be commenced immediately.
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