Patient’s clinical data: Symptomatic 49-year-old white man who presented to the emergency department (ED) with left-sided chest pain.
At the time of admission, there were two consecutive 12-lead ECGs initially performed in the ED. The above ECG was the second of the two that was performed. Why would there be a mandatory need to perform a minimum of two ECGs on this type of a patient?
** *** Both of these images are from the same patient. Please note that the patient’s chest film was performed correctly and is anatomically accurate (i.e., situs solitus) *** **
I’ve included the chest X-Ray (CXR) because it, by far, provides more clarity than an ECG alone ever could.
(1.) What emergent event has brought this patient to the emergency department?
(2.) What has produced this unusual combination of QRS axis and precordial pattern?