ECG Case 2

Question 1

HPC: Mrs Smith is a 56 year old lady brought in by ambulance with severe central chest pain with radiation down her left arm. This has been constant for the last 30 minutes and is associated with sweatiness.

BG: HTN, T2DM, smoker with 30 pack year history.

OE:
General: Clammy, in obvious pain

Obs: RR 22, Sats 93% (OA), HR 75, BP 110/75, Temp 36.5

CVS: CRT <2, HS I+II+O, Pulse regular

Resp: Clear

Answer 1

-

Question 2

This is her ECG. What are the main abnormalities?

Answer 2

• lateral ST elevation (V6)
• deep anterior ST depression (V1-V4)

Question 3

what is happening in leads V1 and V3?

Answer 3

reciprocal ST depression

Question 4

what is the dx?

Answer 4

posterior MI

Question 5

how would you manage this pt?

Answer 5

• morphine (if required)
• O2 (if required)
• GTN
• DAPT
• anticoagulation*
• urgent PCI/thrombolysis