Published: August 4th, 2016

Category: STEMI

Pre-hospital ECG



  • No obvious ST Elevation diagnostic for STEMI, although the anterior depressions can be consistent with posterior MI
  • STEMI Alert cancelled on arrival to ED
  • Urgent Cath performed given patient history and presentation


Cardiac Cath Report

LMCA: short, patent

LAD: Medium-sized, transapical vesse with diffuse disease. Competitive flow in mid LAD segment from LIMA to distal LAD graft. D1 small with severe diffuse disease.

LCX: Medium-sized dominant vessel with mild luminal irregularities. OM1 branch very small with ostial disease. OM2 branch with proximal 90% stenosis (likely culprit) before bifurcation.

RCA: medium-sized, non-dominant vessel with diffuse disease upto 90%, Chronic total occlusion in mid segment.


1. OM branch with obstructive disease however territory supplied by vessel is small and revascularization of this territority will not impact outcome. Recommend medical management.

2. Medical management per CCU team