This post is an answer to the ECG Case 287
- Rate: 78 bpm
- Rhythm: Regular sinus rhythm
- Axis: LAD
- Intervals:
- PR – Normal (~200ms)
- QRS – Normal (100ms)
- QT – 400ms
- Segments:
- ST Elevation in leads II, III, aVF (~1mm)
- Inferior Q waves (rS wave)
- ST Depression in aVL
Interpretation
Inferior OMI.
What happened next ?
Following discussion with cardiology team due to dynamic ECG changes and ongoing chest pain he was taken for urgent coronary angiogram, which showed:
- LMCA – Irregularities
- Prox LAD – Irregularities
- Mid/distal LAD – 70-80%, multiple discrete lesions
- Ostial 1st Diag – 99%, single discrete lesion, small vessel
- Cx – Irregularities
- Prox RCA – 90%, single discrete lesion
- Mid RCA – 100%, unknown length stenosis, heavy thrombus burden
Six stents were inserted into the RCA extending into the PLA. The patient’s stay was complicated by a lower GI bleed which settled without invasive treatment and he was discharge with out-patient cardiology follow-up on dual anti-platelet therapy (DAPT).
READ MORE: ECG Interpretation – All you need to know
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