Answer MI 13

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Previous ECG: MI 12 | Next ECG: MI 14

Where is this myocardial infarction located?

ECG MI 13. Click on image for enlargement.


Answer

Culprit lesion: LAD

  1. sinustachycardia
  2. about 100/min
  3. normal conduction
  4. intermediate heart axis
  5. tall p wave in II consistent with right atrial dilatation. (the sawtooth-basline between the 2nd and 3rd complex in AVR is probably a motion artefact). PTA depression in II
  6. Loss of R waves throughout the anterior wall (V1-V6). QS complexes in V3-V5.
  7. ST elevation in V1-V5 with terminal negative T waves
  • Conclusion: Large anterior MI due to LAD occlusion.

Characteristics that suggest a large infarct in this case are:

  • Loss of R waves throughout the anterior wall (V1-V6). QS complexes in V3-V5.
  • Left and right sided decompensation, resulting in right atrial dilatation and ischemia
  • Tachycardia
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