Three High Risk ECGs and the Right Next Move

ECG Weekly Workout with Dr. Amal Mattu

HPI

A 34 year old man presents with acute chest pain radiating to the left arm associated with diaphoresis. He has hyperlipidemia and a family history of early coronary disease. The following ECG is obtained on arrival and shows ST elevation in aVR and V1 with diffuse ST depression.

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

    1. Is this left main coronary occlusion until proven otherwise?
    2. What other conditions can produce this ECG pattern?
    3. How should the history change what you do next?