STAT ECG Diagnoses: diagnosis of acute myocardial infarction (MI) in patients with paced rhythms

ECG Weekly Workout with Dr. Amal Mattu


An 86-year-old female with PMHx of CAD and pacemaker placement presents to the ED with acute chest pain. Pain has been radiating to the right upper extremity for 1 hour and is associated with shortness of breath. The following ECG is obtained:

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

  1. What ECG abnormalities do you notice?
  2. Are there any ECG findings suggestive of acute coronary occlusion?
  3. Would you emergently activate the cath lab?