Case 146 - A 55 Year-Old Man in the ER with Chest Pain
History
Diagnosis
ECG 2
ECG 2 Diagnosis
ECG 3
ECG 3 Diagnosis
History
A 55 year-old man presents to the ER with a 45 min history of chest tightness associated with diaphoresis and mild shortness of breath.
Diagnosis
- Sinus Rhythm
- ST elevation in V1 to V4 – acute anterior infarction
ECG 2
This ECG is recorded when the patient arrives in the CCU, prior to transfer to the cath lab, about 1 hour after the original ECG was recorded.
ECG 2 Diagnosis
- Sinus rhythm
- Marked ST elevation V3 V4 and 1mm ST elevation inferior leads with ST depression in lead I and AVL – acute anterior infarction and possible acute inferior infarction
ECG 3
This ECG is recorded 12 hours after original presentation, after successful PCI and stenting of the left anterior descending artery.
ECG 3 Diagnosis
- Sinus rhythm
- Evolving anterior myocardial infarction (residual ST elevation but now Q waves and T-wave inversion in V3-V4)
- Inferior myocardial infarction
ECG ID: E806