A 50 year old male presents to ED at 06h45 with chest pain radiating to his left arm which woke him up at 02h00
Below is his ECG
- Describe and Interpret the ECG
- Discuss how you would manage this patient
Answer
Rate: 90 beats per minute
Rhythm: Normal Sinus Rhythm
Axis – normal axis
Interval
PR 200ms
QRS 100ms
QT 441ms (Bazett)
Additional
STE inferiorly III>II, reciprocal ST depressions lateral leads
ST depression V1-V3
The ECG in this clinical context shows an inferior MI with right sided and posterior involvement
Management would include
- dual antiplatelet and heparin therapy
- prepare for complications – defib pads placed on chest, draw up resus drugs including atropine, adrenalin and amiodarone
- analgesia – avoid GTN as patient preload dependent
- 250ml saline boluses if BP drops
- depending on your location reperfusion – PCI vs thrombolysis – know your local protocol!