ST elevation in V1
ST elevation in lead V1 without ST elevation in V2 can be a sign of right ventricular infarction, particularly when also seen with ST elevation in III > II and ST elevation in the right sided lead V4R.
How does acute left main occlusion present on the ECG?
This ECG is from a woman in her 50s who presented with 3 days of intermittent chest pain that became worse on the day of presentation, with diaphoresis and radiation to the left arm, as well as abdominal pain.
This ECG shows widespread ST depression with ST elevation in aVR and V1-2, due to a 100% left main occlusion.
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician
This ECG is from a middle aged patient who presented with chest pain of uncertain duration.
This ECG shows ST elevation in V1 only. This was dynamic on serial ECGs. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician – repeat ECG pain free
This ECG is from a middle aged patient who presented with chest pain of uncertain duration. This was the repeat ECG when pain returned.
This ECG shows ST elevation in V1, II, III and aVF with reciprocal ST depression in aVL. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.
ST elevation in aVL with reciprocal ST depression in the inferior leads
This ECG is from a man in his 50s with a history of thyroid cancer was brought to the Emergency Department after being found minimally unresponsive with sonorous respirations on his couch at home. Blood glucose level was 76 mg/dL. EMS administered naloxone, which was followed quickly by hyperventilation but no improvement in mental status. EMS performed RSI at that time using etomidate and succinylcholine, but intubation was unsuccessful. Luckily, BVM ventilation was easy in this patient, and he was bagged on the way to the ED, with oxygen saturation maintained in the mid-90s. He was intubated immediately on arrival to the ED using ketamine and rocuronium. This was the initial ED ECG.
ST elevation in aVL with reciprocal ST depression in the inferior leads – repeat after calcium
This ECG is from a man in his 50s with a history of thyroid cancer was brought to the Emergency Department after being found minimally unresponsive with sonorous respirations on his couch at home. Blood glucose level was 76 mg/dL. EMS administered naloxone, which was followed quickly by hyperventilation but no improvement in mental status. EMS performed RSI at that time using etomidate and succinylcholine, but intubation was unsuccessful. Luckily, BVM ventilation was easy in this patient, and he was bagged on the way to the ED, with oxygen saturation maintained in the mid-90s. He was intubated immediately on arrival to the ED using ketamine and rocuronium. This was the repeat ECG after calcium had been administered.
ECG Blog #145 – (ST Depression – STEMI – BBB).
A 70-something woman with syncope and a wide complex – change in morphology
A 50-something with h/o coronary bypass has chest pain and a ventricular paced rhythm – 3, 16 min later
This ECG is from a man in his 50s who presented with chest pain on a background of previous CABG and dual chamber pacemaker. This was the repeat ECG 16 min after arrival.
This ECG shows a ventricular paced rhythm with excessive discordant ST elevation in III and aVF, and ST depression in aVL. The cause was an inferior and right ventricular infarction.
“Steve, what do you think of this ECG in this Cardiac Arrest Patient?”
A male in his 50s with chest pain. What is your interpretation? – repeat ECG
A male in his 50s with chest pain. What is your interpretation?
How can you persuade your cardiologist to take a Non-STEMI patient to the cath lab emergently? – 4