Case 137: A 47-Year-Old Man with Chest Pain
History
Diagnosis
ECG 2
ECG 2 Diagnosis
ECG 3
ECG 3 Diagnosis
History
A 47-year-old man is in the Emergency Department with chest pain:
Diagnosis
- Sinus tachycardia, 104/min
- Inferior-posterior injury pattern (ST elevation in II, III and aVF, marked ST depression in V2-V3)
- Acute myocardial infarction
ECG 2
12 hrs. 15 min. after admission second ECG is as follows: 
ECG 2 Diagnosis
- Sinus tachycardia
- Serial changes of evolving acute inferior myocardial infarction
Notice: In the inferior leads the Q waves have increased in width and depth and the ST elevation is less marked. The ST depression in V2 (acute posterior injury) is no longer present and there have been no QRS changes of posterior infarction. In patients with acute inferior infarction it is not uncommon to see acute posterior injury changes without evolutionary QRS changes of posterior infarction.
ECG 3
Third ECG is recorded 22 hrs after admission:
ECG 3 Diagnosis
- Sinus rhythm
- Inferior Myocardial Infarction
22 hours after admission ST elevation is no longer present.
ECG ID: E129