This post is an answer to the ECG Case 242
- Rate: 72 bpm
- Rhythm: Regular Sinus Rhythm
- Axis: Normal
- Intervals:
- PR – Normal (180-200ms)
- QRS – Normal (80ms)
- QT – 360ms
- Segments:
- ST Depression in leads I, II, aVL, V2-6
- ST Elevation in lead aVR (~1mm)
- Additional: Markedly prominent T waves leads I, V2-6
Interpretation
De Winter’s T Wave Pattern suggesting acute LAD lesion requiring emergent reperfusion.
What happened next ?
The ECG changes were recognised by the treating team. The patient was taken for emergency PCI which showed:
- LAD – 100% Occlusion – 2 x stents inserted
- RAC – 30% proximal stenosis
Post stent echocardiogram showed:
- Mild systolic dysfunction
- Akinesis of anterior septum and apical region
- LVEF ~40-45%
The patient was discharged after a 4 day in-patient stay.
READ MORE: ECG Interpretation – All you need to know
