STEMI-26

Published: November 27th, 2015

Category: STEMI

Pre-Hospital ECG

2015-11-27 03.34.46

Emergency Department ECG

Untitled

Cardiac Cath Report:

LAD: mid 100% with some recanalization. Occlusion appears to be just distal to prior DES
LCX: large bifurcating superior OM or OM1
Mid LCX: disease 80% long stenosis
RCA: mid 80%

Plan: Cardiothoracic Surgery consultation for CABG

 

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