12-Lead - Cardiac Ischemia - QUIZ

Question 1

Which artery is most likely to be affected in the context of ST elevation being present in leads V3 and V4?

a) Left circumflex artery
b) Left anterior descending artery
c) Right coronary artery
d) All choices

Answer 1

b) Left anterior descending artery

Question 2

What view of the heart do leads I, aVL, V5 and V6 represent?

a) Septal
b) Inferior
c) Lateral
d) Anterior

Answer 2

c) Lateral

Question 3

Just discharged from hospital after a syncope of unknown origin. Now twitching and malaise. No angina, no dyspnea. Interpret the ECG.

a) Inferior STEMI
b) Anterior STEMI
c) Anteroseptal STEMI
d) Anterolateral STEMI

Answer 3

d) Anterolateral STEMI

Question 4

Increasing pain between the scapula since yesterday, radiating in both arms, but especially the left one. Interpret the ECG.

a) Inferior STEMI
b) Anteroseptal STEMI
c) Anterolateral STEMI
d) Posterior STEMI

Answer 4

b) Anteroseptal STEMI

Question 5

Increasing chest pain during the past two days which is now rapidly worsening. Interpret the ECG.

a) Inferior STEMI
b) Inferior-posterior STEMI
c) Posterior STEMI
d) Lateral STEMI

Answer 5

b) Inferior-posterior STEMI

Question 6

A 67 year old male presents to the ED with epigastric burning and generalized weakness. What does the ECG show?

a) Non-STEMI
b) Subendocardial ischemia
c) OMI
d) Non-cardiac event

Answer 6

c) OMI

Question 7

A 39 year old female presents to the ED with neck and shoulder pain radiating to the right arm. She is pain-free at the time of this ECG.
This ECG is suggestive of which of the following?
Select ALL that apply.
a) Subendocardial ischemia
b) De Winter’s T-wavesChoice 2
c) Wellens syndrome
d) Coronary vasospasm

Answer 7

c) Wellens syndrome

d) Coronary vasospasm

Question 8

Does this ECG show a likely OMI?

Answer 8

Yes

Question 9

Does this ECG show a likely OMI?

Answer 9

Yes

Question 10

Does this ECG show a likely OMI?

Answer 10

No (hyperkalemia can mimic DeWinter’s waves)

Question 11

Does this ECG show a likely OMI?

Answer 11

Yes

Question 12

A man in his early 40s with hyperlipidemia and family history of MI presented at 5:45 AM with acute onset substernal chest pain with nausea and diaphoresis. He reported that the pain began at 8pm last night, and was unclear whether it was constant or intermittent overnight, but his wife convinced him to present to the ED. 
The ECG shows which of the following:
a) Posterior aMI
b) Anteroseptal aMI
c) Global subendocardial ischemia
d) NSTEMI

Answer 12

a) Posterior aMI