Activate or Wait – 011
52-year-old male, previously well, with one hour of central chest pain radiating to left scapula.
We are 10 minutes from your tertiary centre.

ECG interpretation
X
- X
X
Outcome
Key finding:
Evidence of dissection flap and severe aortic regurgitation
Findings:
- Left Main Coronary Artery – Normal
- Left Anterior Descending Coronary Artery – Normal
- Left Circumflex Coronary Artery – Normal
- Right Coronary Artery – Normal
- Aortogram – Evidence of dissection flap and severe aortic regurgitation
Recommendation:
- CTS referral made urgently
- Patient transferred to CT then to OT
Clinical Pearls
- X
References
Further reading
- Buttner R, Burns E. ST Elevation in aVR. LITFL
- Nickson C. Acute Aortic Dissection. CCC
- Nickson C. STEMI Management. LITFL
Online resources
- Wiesbauer F, Kühn P. ECG Mastery: Yellow Belt online course. Understand ECG basics. Medmastery
- Wiesbauer F, Kühn P. ECG Mastery: Blue Belt online course: Become an ECG expert. Medmastery
- Kühn P, Houghton A. ECG Mastery: Black Belt Workshop. Advanced ECG interpretation. Medmastery
- Rawshani A. Clinical ECG Interpretation ECG Waves
- Smith SW. Dr Smith’s ECG blog.
ACTIVATE or WAIT
EKG Interpretation
Adult/Paediatric Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Co-creator of the LITFL ECG Library. Twitter: @rob_buttner
MBBS (Hons), BMSci (Hons). Cardiology Registrar at Royal Perth Hospital in Perth, Australia. Graduate of The University of Western Australia in 2016 with Honours and completed Basic Physician Training with the RACP in 2021. Passion lie in cardiac imaging and electrophysiology.