Two patients with chest pain, with QRS obscured: which was STEMI positive, and which had Occlusion MI?

Written by Jesse McLaren Two patients
presented with acute chest pain, and below are the precordial leads V1-6 for
each. Patient 1 (ECG on the left) was a 45 year-old male, and patient 2 (ECG is
on the right) was a 70 year-old male. The limb leads have been removed because
there was no ST elevation in those leads, the QRS complexes have been
obscured because this is irrelevant to STEMI criteria, and red lines have been added to measure ST segment elevation. Using the
current paradigm, can you tell which patient had an acute coronary occlusion? Using
T wave amplitude, can you tell which ECG has hyperacute T waves? What other parts
of the ECG would you like to see, and how will you use this to refine your
interpretation?   Patient 1                                                   Patient 2STEMI criteria
is based only ST elevation millimeter criteria measured in isolation from the QRS
and stratified by age/sex, so this is the only information provided above. Based
on age/sex, STEMI criteria for both patients is ST elevation in 2 contiguous
leads of 2mm in V2-3 and 1mm in all other leads. You have all the
information you need to apply STEMI criteria: the ECG on the left is STEMI
positive and the ECG on the r...

Source: Dr. Smith's ECG Blog - January 17, 2024 Category: Cardiology Authors: Jesse McLaren Source Type: blogs