A man in his 50s with acute chest pain who is lucky to still be alive.

 Sent by Magnus Nossen MD, written by Pendell MeyersA man in his 50s, previously healthy, developed acute chest pain. EMS was called, and they recorded the following ECG on scene at 13:16:What do you think?Below is the version standardized by PM Cardio appMeyers interpretation:Findings are specific for posterior (and also likely inferior) wall transmural acute infarction, most likely due to acute coronary occlusion (OMI). There is a relatively normal QRS yet there is STD maximal in V2-V4, which resolves from V4 to V6. The inferior leads may have a slightly full T wave (possibly hyperacute if compared to baseline which is unavailable), but there is no clear TWI in aVL.What does the Queen of Hearts say?You can subscribe for news and early access (via participating in our studies) to the Queen of Hearts here: https://bit.ly/omi-queen-formThis EMS ECG was transmitted to the nearby Emergency Department where it was remotely reviewed by a physician, whointerpreted it as normal, or at least without any features of ischemia or STEMI.In this medical system, the EMS provider can then be routed to the ED or to a type of urgent care facility that is open 24 hrs/day and staffed by a primary care provider. In this case, the EMS provider was routed to the urgent care facility.The primary care physician there evaluated this patient and deemed the chest pain to be due to gastrointestinal causes. The ECG was also interpreted as normal by the primary care physician. No troponins ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs