Emergency Department ECG
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
- 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.