Question 10

R_0026_R

Describe the main changes in the ECG (R_0026) of a 35 year old man with chest pain

 

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The main findings are:

  • Sinus rhythm is present with a rate of about 72 beats per minute
  • The inferior leads have Q waves (small Q waves in Lead II and Lead avF, and a deep Q wave in Lead III) and ST elevation (3 mm in Lead II, 4 mm in Lead III and 2 mm in lead aVF)
  • ST elevation is present in Leads V1 to V3 with the elevation ranging from 3 mm to 4 mm. The T waves are also tall in Leads V1 to V3
  • ST depression and T wave inversion are present in Lead I (3 mm of ST depression) and Lead aVL (4 mm of ST depression)
  • Slight ST depression is present in Leads V5 and V6

These changes are diagnostic of an acute ST segment myocardial infarction. The pattern of changes suggests that the culprit vessel is the right coronary artery