Case 164: A 71Year-Old Man Presents to ER with Severe Chest Pain
History
Diagnosis
ECG 2
ECG 2 Diagnosis
ECG 3
ECG 3 Diagnosis
History
A 71 year-old man was awakened with severe chest pain. He called paramedics who treated him with ASA and brought him to the ER. Upon arrival, he was pain free.
Diagnosis
- Sinus rhythm, rate 74/min
- Non-specific ST changes (less than 1mm ST elevation in lead V1 and ST depression in inferior leads)
ECG 2
While in the emergency room, he experiences a recurrence of severe chest pain and a repeat ECG is performed.
ECG 2 Diagnosis
- Sinus rhythm, rate 90/min
- Acute anterolateral infarction (ST elevation V1 to V5 and I/AVL with inferior ST depression
- Premature ventricular complex
ECG 3
The patient was taken urgent to the cardiac catheterization laboratory and found to have an occlusion of the LAD. He underwent successful PCI and stenting. The ECG below was taken 6 hours after original presentation
ECG 3 Diagnosis
- Sinus bradycardia, rate 52/min
- Septal myocardial infarction (Q-waves leads V1/V2)
ECG ID: E817