STAT ECG Diagnoses: early reciprocal changes in patients with cliinical concern for ACS

ECG Weekly Workout with Dr. Amal Mattu


A 87-year-old man reports having 2 days of central chest pain. He starts feeling worse on day 3 and calls an ambulance. Paramedics respond and are highly concerned for ACS based on his symptoms. The following initial prehospital ECG is obtained:

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

  1. What ECG abnormalities do you notice?
  2. Are there any ECG signs of ischemia or is this a normal ECG?
  3. The patient’s symptoms worsen after initial treatment by EMS. What is the next best step in management?