STEMI-11

Published: July 12th, 2015

Category: STEMI

ECG

Cath Report

LMCA: Normal

LAD: Proximal 30% occlusion

LCx: Normal

RCA: Proximal 100% acute thrombotic occlusion

Intervention: Stent placed to RCA

 

Education

  • Inferior MI
    • 40-50% of all myocardial infarctions.
    • more favorable prognosis than anterior myocardial infarction
    • Up to 40% of patients with an inferior STEMI will have a concomitant right ventricular infarction. These patients may develop severe hypotension in response to nitrates and generally have a worse prognosis.
      • Confirmed with Right sided ECG, Elevation in V4R
    • Up to 20% of patients with inferior STEMI will develop significant bradycardia due to second- or third-degree AV block. These patients have an increased in-hospital mortality (>20%).
    • ECG findings
      • ST elevation in leads II, III and aVF
      • Reciprocal ST depression in aVL (± lead I)
      • RCA (80%): Elevation in III > II, Reciprocal depression in I
      • LCx (20%): Elevation in III = II, No reciprocal depression in I

ECG-Anatomy-LITFL