|ECG 60 mins later
Further chest pain
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- Rate 60 bpm
- Regular V-paced rhythm
- LBBB Morphology
- Significant progression of ST and T wave changes
- Massive ST elevation (>5mm) in leads V2-4 also proportionately >25% of QRS depth
- Discordant ST elevation in leads II, III, aVF, V5
- Significantly more pronounced than on previous ECG
- Concordant ST elevation in leads I and V6
- Sgarbossa positive ECG’s
- Dynamic and progressive ST segment changes
- Underlying V-paced rhythm with LBBB morphology
What happened ?
The patient was discussed with the cardiology team and taken for angiography.
This showed an acute mid LAD occlusion treated with a bare metal stent. Post angiography echo showed moderate systolic and diastolic dysfunction. She was discharged following a 2 day in-patient stay.
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.