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This post is an answer to the ECG Case 280

• Rate: 120 bpm
• Rhythm:
  • Regularly irregular
  • Bigeminy – Alternating sinus complex and PVC
• Axis:
  • Sinus complex – normal axis
  • PVC – extreme axis
• Intervals – Sinus Complex:
  • PR – Normal (~200ms)
  • QRS – Normal (100ms)
  • QT – 480ms

• Intervals – PVC’s:
  • QRS – Prolonged (120ms)
• Segments – Sinus complexes:
  • ST Elevation in leads V2 (2mm) V3 (3mm) V4 (2mm) V5 (2mm) V6 (1mm)
• Additional:
  • T inversion in lead aVL
  • Hyperacute T waves in leads V2-4
  • Excessive discordant ST elevation in the PVC’s leads V2-6

Interpretation

• Antero-lateral STEMI
• Bigeminy

What happened ?

The patient was taken for urgent angiography and PCI and has a mid-LAD lesion stented.

READ MORE: ECG Interpretation – All you need to know