Here's a case submitted by a faithful reader who wishes to remain anonymous. He has submitted several cases before and they are always excellent so thank you, Mr. Anonymous!
EMS is called to the residence of a 69 year old female who is complaining of sudden onset of shortness of breath and weakness.
- Past medical history: Healthy
- Medications: None
The patient is seen in the emergency department of a local community hospital where she is found to have slight J-point elevation in the anterior leads.
(The vital signs and results of the physical exam are not available.)
Approximately 2 hours later there is a slight change in ST-segment morphology and new T-wave inversion in lead aVL. A cardiologist is consulted via telemedicine at the tertiary care center and the decision is made to transfer the patient.
Concurrently with this decision the patient is given 3 doses of SL NTG with complete resolution of her symptoms.
The transport ambulance arrives and records the following 12-lead ECG.
Several more are recorded en route. Here's the ECG captured on arrival at the PCI-hospital.
Do you think this patient is having a STEMI? Why or why not?