SUBTLE ST CHANGES This ECG was obtained from an 87-year-old man who was experiencing chest pain. Due to the subtle ST elevation in Leads II, III, aVF, V5, and V6, (inferior- lateral walls) the ECG was transmitted to the hospital by the EMS crew, and the cath lab was activated. The patient denied previous cardiac history.
This ECG was obtained from a patient who suffered an obstruction of the circumflex coronary artery. Unfortunately, he was in the approximately 15-18% of the population in whom the circumflex artery is dominant. That means that it connects with the posterior descending artery, perfusing not only the lateral wall of the left ventricle, but also the posterior and inferior walls. In this case, the obstruction is in the midportion of the artery, and the high lateral wall is spared.
This ECG and rhythm strip are from a 78 year old man with chest pain, but we have no other clinical data. This is a good example of inferior and low lateral injury, demonstrating the large amount of heart muscle that can be damaged when a dominant RCA or circumflex artery is occluded. The low lateral wall is often included in an inferior wall M.I. when the RCA wraps around the left side of the heart, or the circumflex perfuses the posterior descendng artery and the inferior wall.
This is from a Cardiac Alert patient, with chest pain, in the Emergency Department. The ECG shows ST elevation in the inferior leads (II, III, and aVF), and in the low lateral leads (V5 and V6). There is reciprocal depression in V1 and V2, indicating injury in the posterior wall. One could argue that "inferior" is just the term we use for the lower part of the posterior wall - the part that faces the floor in a standing person.
All our content is FREE & COPYRIGHT FREE for non-commercial use
Please be courteous and leave any watermark or author attribution on content you reproduce.