Emergency Department ECG:
Cardiac Cath Report:
1. LMCA: Large, widely patent, gives rise to the LAD and LCX.
2. LAD: Large, transapical, proximal 95% stenosis with mild thrombus. D1 small and patent, D2 very small and patent.
3. LCX: Large, nondominant, large OMB1 and OMB2 are patent, patent ongoing LCX in AV groove.
4. RCA: Large, dominant, widely patent, patent right PDA.
PLAN: Successful stent placement in proximal LAD
- 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.