Let’s start with the story: Medicine team was called in middle of night to see disruptive patient on psychiatry floor with an hour or so of chest pain and this EKG.
+ EKG Interpretation
Dr. Ohlbaum's Explanation
Starting at the beginning, there are P waves followed by QRS complexes and underlying rhythm is sinus but there are frequent PVC (early, wide, funny looking with compensatory pauses). The P waves look normal.
There are small Q waves in the inferior leads, right at that quarter of the height of the QRS that would be significant. There is ST elevation in II, III, and AVF. INFERIOR ST ELEVATION MI. There is also ST depression in V1,2,and 3 suggesting POSTERIOR wall injury as well.
SINUS RHYTHM WITH FREQUENT PVC, INFERIOR/POSTERIOR STEMI
Pt was sent to cath lab emergently, 100% mid rca occlusion and stent placed. The patient has done well.