- Sinus rhythm, rate 50/min
- First degree block (PR interval 350 ms)
- Normal axis
- Small Q waves in leads II, III, VF
- Raised ST segments in leads II, III, VF
- Depressed ST segments and inverted T waves in leads I, VL
- Slight ST segment depression in the chest leads maximal in leads V2 and V3 indicating posterior MI
Acute inferior and posterior ST segment elevation myocardial infarction (STEMI), and first degree block. Patients who are in pain with an acute myocardial infarction usually have a sinus tachycardia, but here vagal overactivity is causing a bradycardia.
What to do ?
This patient can be treated in the usual way with pain relief, aspirin, and percutaneous coronary intervention (PCI) or thrombolytics.
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