This is the conclusion to 71 year old male CC: Chest pain.
Thanks for all the great comments!
Let’s take another look at the 12-lead ECG.
This 12-lead ECG shows acute anterior ST-elevation myocardial infarction.
Significant ST-elevation is present in leads V2-V5, I and aVL with reciprocal ST-depression in leads III and aVF.
A “STEMI Alert” was called from the field and the ECG was transmitted to the emergency department.
The patient was treated with MONA and the following 12-lead ECGs were recorded en route to the hospital.
The T-waves remain hyperacute but there is significant regression of ST-elevation. Remember, hyperacute T-waves are the best indicator of viable myocardium at risk!
When the paramedics (and their patient) arrived at the hospital the cath team was waiting.
Angiography revealed a 99% occlusion of the LAD. The lesion was crossed with a wire, the balloon inflated, and a stent was successfully placed with TIMI 3 flow restored (successful reperfusion).
After a short stay at the hospital the patient was discharged home.
Discharge diagnosis: ST-elevation myocardial infarction
it’s interesting how hyperacute T isn’t as drilled into the heads of providers as STE.
My friend is a doctor, who graduated from Columbia University’s College of Physicians & Surgeons. Yet he’s always saying he’s “always had trouble interpreting EKGs.”
He’s not a cardiologist. He worked in ENT and was an Ear, Nose and Throat specialist. But he had to read EKG’s in his intern, and he always went to a cardiologist to get a second opinion.