Literature Review: occlusion MI in paced rhythms

Emergency Cardiology Literature Review & Updates with Dr. Amal Mattu


HPI:  An 84-year-old male presents to the emergency department with 4 hours of chest pain. He has a history of coronary artery disease and has a pacemaker. The following ECG is obtained:

Case ECG

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is the most likely cause of the ST-segment abnormalities seen?
  3. Would you activate the cath lab?


A father calls an ambulance for his 16-year-old daughter who is not feeling well. She has been listless and having palpitations. She is found to be tachycardic with a normal blood pressure on arrival to the emergency department. The following ECG is obtained: