Elderly patient presenting with chest pain. Interpret the ECG.
Describe and interpret this ECG
ECG ANSWER and INTERPRETATION
The LV aneurysm pattern refers to the combination of residual ST elevation, deep Q waves and inverted or biphasic T waves seen in patients following an acute myocardial infarction. This ECG pattern is associated with transmural scarring and paradoxical movement of the LV on wall on echocardiography.
Around 60% of patients with anterior STEMI develop some degree of chronic ST elevation on their ECG, which can cause diagnostic confusion.
If these patients present with chest pain, the safest approach is to take serial ECGs looking for signs of evolving STEMI such as evolving ST elevation or pseudo-normalisation of T waves.