Unrecognized Killers in Emergency Electrocardiography, Part III

ECG Weekly Workout with Dr. Amal Mattu

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HPI

A 55-year-old woman with a history of hypertension, diabetes, and tobacco use presents to the emergency department with chest heaviness and shortness of breath. Her initial ECG raised immediate concern for STEMI, prompting activation of the cath lab. Unfortunately, approximately 10 minutes into the PCI procedure, the patient suffers a brady-asystolic arrest and resuscitation efforts are unsuccessful. 

Before watching this week’s workout, carefully review the ECG and consider the following:

1. 1. How would you interpret this ECG, and are there any findings or red flags suggesting an alternative diagnosis other than STEMI? If so, what are they?
   2. Given the outcome, what critical step might have prevented this patient’s rapid deterioration?