Like a bridge over troubled waters

aka Cardiovascular Curveball 014 A 38yo man presented to ED with a 2 hour history of central crushing chest pain. His past medical history included haemochromatosis and a negative stress echo done one year ago following an episode of chest pain which the patient describes as different to the pain that bought him to the emergency department today. An ECG is done: Q1. Describe this ECG. + Reveal Answer expand(document.getElementById('ddet317893350'));expand(document.getElementById('ddetlink317893350')) The ECG demonstrates underlying sinus rhythm with a rate of 75 bpm and normal axis. antero-lateral ST elevation. auto-analysis of the ECG states ‘ACUTE MI’. The patient looks well. His observations are normal, and despite aspirin and GTN he is still complaining of 7/10 chest pain. Q2. Is the auto-analysis interpretation correct? Is this an Acute MI? + Reveal Answer expand(document.getElementById('ddet237025508'));expand(document.getElementById('ddetlink237025508')) Thankfully Prof. Steve Smith, an emergency physician and creator of Dr Smith’s ECG Blog thinks he can help… Dr Smith has created a formula using logistical regression to aid in differentiating between subtle anterior STEMI and benign early repolarisation (BER). This formula is to be used when the diagnosis is in doubt i.e. not an obvious STEMI and no LVH, LBBB, or reciprocal ST depression. [Original Article] [Blog Reference] The formula: Subtle Anterior STEMI Calculation = (1.1...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Cardiology ECG Investigation Acute MI BER bridge bridging cardiovascular curveball myocardial bridge STEMI Source Type: blogs