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62 year old male CC: chest discomfort (update)

4 comments

I was wrong.

There, I said it.

Someone please let my girlfriend know.

The culprit artery for the 62 year old male complaining of chest discomfort was the LCX, not the RCA as I suspected.

I'm trying to figure out how to load the DICOM images into a format viewable on my blog (so you can see the live-action angiograms).

In the meantime, here are the still images. Discussion to follow.

Before – proximal occlusion of the LCX

Before – Proximal occlusion of the LCX

After – Note how the distal LCX branches off and supplies the inferior wall

After – Note how the distal LCX branches off and supplies the inferior wall

Very small and non-dominant RCA

 

See also:

Acute inferior STEMI – RCA or LCX?

Posted by on July 23, 2009 • Filed under: ems-topics, patient-management • Tagged: , , , , , , , , , , , , ,

4 Comments

  1. SoCal Medic says

    Is there a way you can differentiate between the two based on the 12 Lead?

    on July 23, 2009 @ 7:16 pm.
  2. Tom B says

    Good question! It sure looked like an RCA to me. I'm going to address this in an upcoming post.Tom

    on July 23, 2009 @ 8:23 pm.
  3. Neil Holtz says

    Yes. you can certainly distinguish the difference between LCx and RCA by the involvement of lead 2. It is an issue of vector of conduction of the ischemic area. I have a ton of angiograms and ACS ECG's that tell the tale. I also know how to post your dicom images too

    on June 1, 2011 @ 1:17 pm.

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Continuing the Discussion

  1. 62 yom CC: chest discomfort – Prehospital 12-Lead ECG linked to this post

    [...] the update, including angiograms HERE. Share and [...]

    on December 12, 2010 @ 4:00 pm.