ECG Guru - Instructor Resources - Obtuse marginal artery https://www.ecgguru.com/ecg/obtuse-marginal-artery en Acute M.I.: Occluded Stents in Left Obtuse Marginal Artery https://www.ecgguru.com/ecg/acute-mi-occluded-stents-left-obtuse-marginal-artery <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/acute-mi-occluded-stents-left-obtuse-marginal-artery"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/CAD107.jpg" width="1800" height="979" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>This ECG illustrates what some would call a non-ST-elevation M.I., but may also illustrate the limitations of a standard 12-Lead ECG. &nbsp;This female patient in her 60's presented to the Emergency Department with vague chest discomfort. &nbsp;She was cool and diaphoretic. &nbsp;She gave a history of having coronary artery stents placed in the past. &nbsp;On angiography in the cath lab, she was found to have two stents in her obtuse marginal artery which were occluded. &nbsp;Her case was lost to followup.</p><p>The ECG shows ST depression in anterior leads V2 through V6, as well as in the inferior leads, although very subtle. &nbsp;The inferior leads' ST segments are more horizontal than depressed, but flat and horizontal is not normal. &nbsp;She shows a bit of upward concavity or slight elevation in V1, Lead I, and aVL. &nbsp;These signs might be missed by someone looking only for ST ELEVATION. &nbsp;Additional left lateral and posterior leads were not done, and we have to wonder if she would have had some ST elevation in V7 or V8.</p><p>Her rhythm is very interesting too. &nbsp;Often, ischemic hearts produce abnormal rhythms, and it is not unexpected. &nbsp;The rate and the rhythm caused this patient no difficulties during her time in the ED. &nbsp;On first glance, her QRS complexes appear to be "grouped", as they would in a Wenckebach type block. &nbsp;On closer inspection, you will see two distinctly different P waves, and no non-conducted P waves. &nbsp;This appears to be a sinus rhythm with frequent PACs. &nbsp;The PRI is prolonged at .28 sec., which also is not unusual for M.I. patients.</p><p>We are very interested to hear what YOU think about this interesting ECG, including the rhythm. &nbsp;We are hoping to hear from people from all areas of cardiac care - what do you think are the main teaching points of this case?</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/364/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Acute M.I.: Occluded Stents in Left Obtuse Marginal Artery 1/5</option><option value="40">Give Acute M.I.: Occluded Stents in Left Obtuse Marginal Artery 2/5</option><option value="60">Give Acute M.I.: Occluded Stents in Left Obtuse Marginal Artery 3/5</option><option value="80" selected="selected">Give Acute M.I.: Occluded Stents in Left Obtuse Marginal Artery 4/5</option><option value="100">Give Acute M.I.: Occluded Stents in Left Obtuse Marginal Artery 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.2</span></span> <span class="total-votes">(<span >5</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-u-S2LJCfYwgqsTgbhfRMRke1haPeDX6ZADSVFYhR_Eg" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/obtuse-marginal-artery" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Obtuse marginal artery</a></div><div class="field-item odd"><a href="/ecg/nstemi" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">NSTEMI</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Facute-mi-occluded-stents-left-obtuse-marginal-artery&amp;title=Acute%20M.I.%3A%20Occluded%20Stents%20in%20Left%20Obtuse%20Marginal%20Artery"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Sun, 28 Jul 2013 21:02:54 +0000 Dawn 477 at https://www.ecgguru.com https://www.ecgguru.com/ecg/acute-mi-occluded-stents-left-obtuse-marginal-artery#comments