ECG Case 97: Old Inferior MI and Frequent Multifocal Ventricular Extrasystoles

ECG Intepretation

  • Sinus rhythm, rate 88/min, with frequent multifocal ventricular extrasystoles
  • Normal PR interval
  • Normal axis
  • Q waves in leads II, III, VF
  • T waves flattened or inverted in the sinus beats in leads II, III, V5–V6

Old Inferior MI and Frequent Multifocal Ventricular Extrasystoles

Clinical Interpretation

The ECG shows a probable old inferior myocardial infarction, which accounts for his angina. Ventricular extrasystoles are in themselves usually not important, but in a patient complaining of attacks of dizziness, ventricular extrasystoles that are frequent and multifocal may be causing haemodynamic impairment.

What to do ?

It would be worth recording an ambulatory ECG to see if the patient is having runs of ventricular tachycardia, but the extrasystoles probably do need suppressing. A beta-blocker would be the first drug to try.