EKG of the Week
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This EKG was done on a 73 yo man with hx HTN who presented with acute onset of chest pain associated with dizziness and diaphoresis.
+ EKG Interpretation
Dr. Ohlbaum's Explanation
The rhythm is regular, there are normal looking P waves before every QRS and nothing missing and nothing extra so it is sinus rhythm. The rate is 60 so it is normal sinus rhythm (though on the low edge). The P wave is normal. The PR is normal. The QRS is normal in duration. The axis is normal. The voltage is generous but not quite enough for LVH.
So far so good. But what about those ST's. He has clear ST elevation in the inferior leads, and a little in V6 suggesting inferolateral INJURY, or inferolateral STEMI. He has no Qs (yet) to suggest completed event. He also has deep ST depression in the right precordial leads suggesting posterior wall injury as well.
So ... NSR, ACUTE INFEROLATERAL AND PROBABLY POSTERIOR WALL STEMI. The patient was taken acutely to the cath lab where he was found to have 100% stenosis of a large distal right coronary artery which was stented emergently.
