Multi-vessel disease

Multi-vessel disease can cause a variety of different ECG signs. It is one of the differentials for ST elevation in aVR.

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ECG Library (22)

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In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST elevation Bifascicular block LAFB RBBB Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
What is the Diagnosis in this 70-something with Chest Pain? 31294

This ECG is from a man in his 70s who presented with chest pain.

This ECG shows RBBB, LAFB and ST elevation V2-4. The troponin was very high due to a very large infarct. The cause was 3 vessel disease. The rhythm is also grouped, possibly bigeminy.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST depression Inferior ST elevation Pathological Q waves Acute Inferior MI Acute Posterior MI Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
Acute MI, pain onset 24-48 hours ago. Should the patient go for emergent angiogram/PCI? 30678

This ECG is from a man in his 60s who presented with chest pain for 48h with diaphoresis.

This ECG shows inferior ST elevation with reciprocal depression in aVL and I. ST depression in V2-4. Deep Q waves inferior leads and tall R waves V1-3. The cause was a completed infarction with 2 likely culprits (RCA and circumflex).

In the ECGquest archives, this ECG has been tagged with: - 12-Lead ST elevation in aVR Widespread ST depression Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
An 80 year old man in VF arrest 30189

This ECG is from an elderly man who presented in VF cardiac arrest and had return of spontaneous circulation after 4 shocks.

This ECG shows junctional bradycardia with diffuse ST depression and ST elevation in aVF. The cause was severe triple vessel disease.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Wandering baseline Excessive discordant ST depression. Excessive discordant ST elevation Pacemaker spikes Regular Tachycardia Wide QRS Ventricular pacemaker Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
Can you see through this wide complex rhythm? 28777

This ECG is from a man in his 70s who presented with intermittent dyspnoea and chest pain over the past 2 weeks. He had a history of a pacemaker, heart failure, aortic stenosis, diabetes, hypertension, stroke, ischemic heart disease, chronic kidney disease and peripheral vascular disease. This was his initial ECG.

This ECG shows a wide complex tachycardia with ventricular pacing. The excessively discordant ST changes in V4-6 and aVR suggested diffuse subendocardial ischemia. He was found to have severe three vessel disease and a proximal left circumflex stenosis was stented.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Absent P waves Anterior ST depression Extreme tachycardia Inferior ST elevation Narrow QRS Normal Axis Reciprocal ST depression Regular Tachycardia Atrial flutter Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide. 28056

This ECG is from a man in his 60s who presented with intermittent shortness of breath and chest pressure over the past few days. This was his initial ECG.

This ECG shows a regular narrow complex tachycardia around 200 bpm, without P waves, with marked ST elevation in inferior leads and ST depression in anterior leads and aVL. The cause was thought to be atrial flutter from newly started flecainide. He also underwent angiography and had stents inserted to the left circumflex and right coronary arteries.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Anterior ST depression Inferior ST elevation Narrow QRS Normal Axis Normal P waves Reciprocal ST depression Regular Tachycardia Sinus tachycardia Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide. Repeat 1 min later. 28734

This ECG is from a man in his 60s who presented with intermittent shortness of breath and chest pressure over the past few days. This was his repeat ECG after the rhythm changed.

This ECG shows a sinus tachycardia with ST elevation in inferior leads and ST depression in anterior leads and aVL. He underwent angiography and had stents inserted to the left circumflex and right coronary arteries.

In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest 12-Lead Anterior ST depression ST elevation in aVR Atrial fibrillation Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
Cardiac arrest #3: ST depression, Is it STEMI? or is he an ACCESS Trial Candidate? 19557
In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest Dyspnoea 12-Lead Anterior ST depression Inferior ST depression Lateral ST elevation Wide QRS Acute Lateral MI Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
Another Cardiac Arrest – Is it OMI this time? Use your skills from the previous post! 19471

This ECG is from a male in his 40s who developed sudden shortness of breath and arrested soon after. This was the initial ECG after 5 shocks for VT/VF when he was intubated and without any spontaneous movements.

This ECG shows wide QRS with massive ST depression in V1-5, II, II, aVF and ST elevation in I and aVL caused by acute posterolateral MI. The ST segments were initially misinterpreted as being part of the wide QRS complexes.

In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest Dyspnoea 12-Lead Anterior ST depression Inferior ST depression Lateral ST elevation ST elevation in a PVC Wide QRS Acute Lateral MI Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
Another Cardiac Arrest – Is it OMI this time? Use your skills from the previous post! Repeat 23min later. 29174

This ECG is from a male in his 40s who developed sudden shortness of breath and arrested soon after. This was the initial ECG after 5 shocks for VT/VF when he was intubated and without any spontaneous movements.

This ECG shows high lateral ST elevation. Within the PVCs there is excessive discordant ST elevation in I and aVL, as well as excessive depression in II, III, aVF, V5 and V6. The cause was an acute posterolateral MI. The ST segments were initially misinterpreted as being part of the QRS complexes.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead ST elevation in aVR Widespread ST depression Diffuse subendocardial ischaemia Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
ST-Elevation in aVR with diffuse ST-Depression: An ECG pattern that you must know and understand! 18206