ECG Basics and Fundamentals: subtle early signs of acute cardiac ischemia

ECG Weekly Workout with Dr. Amal Mattu


A 57-year-old man presents to the emergency department with chest pain concerning for MI. The following ECG is obtained with no prior ECGs available for comparison. Cardiology is contacted and declines cath as there is no STEMI criteria.

Before watching the video, look closely at this ECG and ask yourself:

  1. What ECG abnormalities do you notice?
  2. Does a recent negative stress test rule out the possibility of CAD or ACS?
  3. How would you manage and disposition this patient?