ECG Case 82: Acute Antero-Lateral STEMI and Left Anterior Fascicular Block (LAFB)

ECG Interpretation

  • Sinus rhythm, rate 100/min
  • Left axis deviation
  • QS waves in leads V1–V4
  • Q waves in leads I and aVL
  • Raised ST segments in leads I, aVL, V1–V6
  • Reciprocal ST depression in inferior leads (II, III, aVF)

Acute Antero-Lateral STEMI and left anterior fascicular block (LAFB)
Acute Antero-Lateral STEMI and left anterior fascicular block (LAFB)

Clinical interpretation

This ECG shows left anterior hemiblock, with an acute ST segment elevation anterolateral myocardial infarction (STEMI).

What to do?

Unless there are any potential risks of bleeding (previous stroke, peptic ulcer, diabetic retinopathy, etc.), this patient should be given aspirin, 300 mg to be chewed, and immediate percutaneous coronary intervention (PCI), or immediate thrombolysis if PCI is not available.