STEMI-61

Published: May 2nd, 2016

Category: STEMI

Pre-hospital ECG

ZE00008349_20160502_051816

Emergency Department ECG

Untitled

Cardiac Cath Report

LM- Normal caliber, patent

LAD- Normal caliber, transapical, diffuse mild luminal irregularities. D1large, patent

LCx- Normal caliber, proximal patent, OM 1 large, mild disease. OM 2 large, 80% mid stenosis. AV groove LCx small patent

RCA- Large, dorminant, proximal- 80% hazy stenosis, mid and distal moderate diffuse disease. PDA 95% mid stenosis.

Stent placed to mid RCA

 

Teaching

Inferior MI

  • 40-50% of all myocardial infarctions.
  • more favorable prognosis than anterior myocardial infarction
  • Up to 40% of patients with an inferior STEMI will have a concomitant right ventricular infarction. These patients may develop severe hypotension in response to nitrates and generally have a worse prognosis.
    • Confirmed with Right sided ECG, Elevation in V4R
  • Up to 20% of patients with inferior STEMI will develop significant bradycardia due to second- or third-degree AV block. These patients have an increased in-hospital mortality (>20%).
  • ECG findings
    • ST elevation in leads II, III and aVF
    • Reciprocal ST depression in aVL (± lead I)
    • RCA (80%): Elevation in III > II, Reciprocal depression in I
    • LCx (20%): Elevation in III = II, No reciprocal depression in I

ECG-Anatomy-LITFL