STEMI-21

Published: October 13th, 2015

Category: STEMI

Pre-hospital ECG:

IMG_3388

Emergency Department ECG:

ECG1-1

Cardiac Cath Reort:

LM- normal caliber, no angiographic stenosis
LAD- Proximal 100% occlusion
LCx- Moderate to Large LCx with proximal 20%.
RCA- Dominant RCA near normal with normal PDA

Severe left Ventricular Dysfucntion

Teaching:

Anterior 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