This ECG was obtained from a 35-year-old man who was complaining of crushing substernal chest pain which radiated down his left arm for the last ten minutes. He was diaphoretic, and described his pain as a “10” on the 1-10 scale. He got only modest relief from IV fentanyl.
Anterior wall M.I.
This ECG is taken from an elderly man who has a history of complete heart block and AV sequential pacemaker. On the day of this ECG, he presented to the Emergency Department with chest pain and shortness of breath. His vital signs were stable and within normal limits. We do not have information about his treatment or outcome.
Intermittent chest pain. This series of three ECG were taken from a 41-year-old man with a two-week history of intermittent chest pain. At the time of the first ECG, 12:05 pm, he was pain-free. We see a sinus tachycardia at 102 bpm, and has just come under the care of paramedics. There is a very subtle ST sagging and T wave inversion in Lead III, and no other ST changes. He had an uneventful trip to the hospital.
This ECG is from a 54-year-old woman who had an M.I. one week prior to this tracing. She did not receive interventional treatment, as it was not available where she lived when this happened years ago. Her ECG shows the signs of healing injury, as well as probable permanent damage.
This is a very interesting ECG taken from an acute M.I. patient. Your basic level students will be able to appreciate the ST elevation in V1 through V3. Although the elevations are not very high, there are plenty of other abnormalities that point to acute STEMI: the ST segments are flat and there are marked ischemic T waves in the lateral leads: V4 through V6 and I and aVL. The patient was suffering an acute episode of chest pain.
Today’s ECG of the WEEK comes from Sebastian Garay, Paramedic. He presented it on his excellent website CardioCareConcepts.com, and was kind enough to share it with the ECG Guru. It is a great example of LEFT MAIN CORONARY ARTERY lesion with ST elevation in aVR and V1.
This ECG was taken from a 60 year old man who was complaining of severe substernal chest pain, radiating to his left arm and a non-productive cough. There was some initial discussion among the EMS crew about the possibility of the ECG showing a "benign early repolarization" pattern because of the concave upward ("smiling") ST segments.
A series of ECGs can be a valuable addition to any teacher's collection. This series follows a 75-year-old woman through three days, during which she experienced an acute anterior wall M.I., a catheterization with angioplasty and stents placement.
This ECG depicts an extensive and ultimately, fatal, injury. There is marked ST segment elevation in Leads V2 through V6 (anterior wall). There is also ST elevation in Leads I and aVL (high lateral wall). The ST elevation in aVR is indicative of a very proximal lesion in the left coronary artery, which supplies the anterior wall, including the anterior portion of the septum, the high lateral wall, and, in this case, the low lateral wall. The inferior leads, II, III, and aVF, show reciprocal ST depression.
This 88-year-old woman was brought to the Emergency Department in cardiogenic shock. Very little is known of her past medical history, but it was relayed to the EMS responders that she had been ill for about four days, when she became much worse.
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