ECG of the Week – 24th April 2019 – Interpretation

The following ECG is taken from a 82 year old non-English speaking lady whose family states she woke feeling unwell and with a funny feeling in her left arm:

Questions:

  1. What are the ECG features seen?
  2. Discuss management.
ECG Features:-
Rate: 60
Rhythm: NSR
Axis: Normal
Morphology: Inferior STE >3mm with up to 3mm reciprocal STD in I, aVL, V2-V6
Intervals: Wenckebach / Mobitz type I Second degree heart block
Summary: Inferior STEMI with AV Block
Management:-
Code STEMI (presented out of hours, transferred to RPH)
Aspirin, Ticagrelor, Heparin, Morphine
Progress:-
Developed bradycardia during transfer to rate of 40
Found to have RCA stenosis on angio
Further Reading:-
  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.