ECG Case 064

Chest pain and diaphoresis. BP 80/50. Describe and interpret his ECG

TOP 100 ECG QUIZ LITFL 064

Describe and interpret this ECG

ECG ANSWER and INTERPRETATION

Key Abnormalities

  • There is ST elevation in the inferior leads II, III and aVF.
  • The concave morphology might lead you to suspect pericarditis – however, there is reciprocal change in the high lateral leads I and aVL, confirming the diagnosis of inferior STEMI.

There are additional features suggestive of right ventricular infarction:

  • ST elevation in III > II
  • Isoelectric ST segment in V1 with ST depression in V2

Other Abnormalities

  • There is a break in the rhythm towards the end of the rhythm strip, with what appears to be a non-conducted P wave, suggesting the development of 2nd degree AV block — e.g. a slowly-evolving Wenckbach cycle.
  • The 13th QRS complex appears to be a supraventricular ectopic beat (PAC or PJC).

TOP 100 ECG SERIES


Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. He has a passion for ECG interpretation and medical education | ECG Library |

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