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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.

4149
Would you activate your cath lab/STEMI protocol?

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:

  1. CTS referral made urgently
  2. Patient transferred to CT then to OT
Clinical Pearls
  • X

References

Further reading

Online resources


ACTIVATE or WAIT

EKG Interpretation

MBBS (UWA) CCPU (RCE, Biliary, DVT, E-FAST, AAA) Adult/Paediatric Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor-in-chief of the LITFL ECG Library. Twitter: @rob_buttner

Dr Amro Sehly LITFL author cardiology

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.

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