STEMI-30

Published: December 11th, 2015

Category: STEMI

Emergency Department ECG

ECG1

Cardiac Cath Report

LM – 30% ostial Stenosis

LAD100% occlusion at the mid segment. Diffuse disease was seen distally following restoration of flow

LCx – Normal Caliber, Patent

RCA – Dominant Vessel, normal caliber, patent.

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