ECG of the Week – 26th March 2018 – Interpretation

The following ECG is from a 45 yr old male who presents following an Out-of-Hospital Cardiac Arrest (OOHCA). He regained cardiac output en route to the Emergency Department.


Click to enlarge

Rate:

  • 96 bpm

Rhythm:

 

  • Irregular
  • Nil P waves 

Axis:

  • LAD

Intervals:

  • QRS – Normal

Segments:

  • ST Elevation leads I (6mm), aVL (7mm), V6 (1mm)
  • ST Depression leads II, III, aVR, aVF, V1-5

Additional:

  • Late R wave transition

Interpretation:

  • High lateral STEMI
  • Atrial fibrillation 


What happened ?

The patient was transferred for urgent angiography and underwent stenting of a 1st Diagonal branch occlusion.
 
Further reading
 
All EM Physicians should be aware of their relevant National resuscitation guidelines.
The Australian Resuscitation Council has a set of comprehensive guidelines which can be found here:

 Here is a concise and quick review regarding some of the key considerations in a post-ROSC care plan from R.E.B.E.L.EM:

 References / Further Reading
 
Life in the Fast Lane
 

Textbook

 

  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.

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