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This post is an interpretation of the ECG Case 199

• Rate: 78/min
• Rhythm:
  • Regular
  • Sinus Rhythm
• Axis:
  • Normal (+45 deg)
• Intervals:
  • PR – Normal (~200ms)
  • QRS – Normal (80-100ms)
  • QT – 360ms (QTc Bazette ~ 400 ms)

• Segments:
  • Slight ST Elevation in Lead II
  • ST Elevation in V2-3 (~1mm)
  • ST Elevation in V4 (Variable magnitude with wandering baseline)
• Additional:
  • T Wave Inversion in Leads I, aVL
  • T Flattening in V6
  • Positive T wave in V1
  • Biphasic T waves in V2-V4

Interpretation

• Type 2 Wellen’s Pattern
• High lateral ischaemic changes
• Anterior ST elevation
• Patient requires urgent cardiology consultation given high likelihood of critical LAD lesion and risk of anterior wall AMI.

SIMILAR CASES:

• ECG Case 154: Wellens’ syndrome
• ECG Case 63: Wellens Syndrome (Critical stenosis of the left anterior descending artery (LAD))