STEMI-18

Published: August 29th, 2015

Category: STEMI

Pre-hospital ECG:

Photo Aug 29, 7 37 51 AM

Emergency Department ECG:

ECGY

Cardiac Cath Report

LAD: 100% mid occlusion

LCx: 60% mid occlusion

RCA: 70% proximal stenosis

Procedure: stent placed to mid LAD

Teaching

Anterolateral MI

  • 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.

ECG-Anatomy-LITFL