Emergency Dept ECG 1
Cardiac Cath Report
LM: Large caliber vessel. Patent. 15-20% mid stenosis.
LAD: Large caliber vessel. Transapical. No significant focal stenosis proximaly. Moderate diffuse disease in its mid portion up to 60%. Acute 100% thrombotic occlusion of the distal LAD
Ramus: Large caliber, long. Proximal 80% stenosis.
LCx: Small caliber vessel. Mild intraluminal irregularities. No significant focal stenosis.
RCA: Medium sized. Dominant. 100% chronic total occlusion at its mid portion. Filling via L to R collaterals from the LAD.
Procedure: 1 stent placed to distal LAD
- Carries the worst prognosis of all infarct locations, mostly due to larger infarct size
- ECG findings in V1-V3
- ST segment elevation with Q wave formation in the precordial leads (V1-6) ± the high lateral leads (I and aVL)
- Precordial leads
- Septal leads = V1-2
- Anterior leads = V3-4
- Lateral leads = V5-6
- Site of LAD occlusion (proximal versus distal) predicts both infarct size and prognosis.
- Proximal LAD / LMCA occlusion has a significantly worse prognosis due to larger infarct size and more severe hemodynamic disturbance.