What it looks like: inferior STEMI

No mysteries here today – this is an inferior STEMI! But I thought that prehospital provider might like to see what happens “on the inside” during an MI. The Case: A 60-something female had a few days of feeling not quite right, so she did some Googling, and she began to worry about a heart attack. Therefore, when she acutely developed neck and jaw pain, she figured that her self-diagnosing was probably correct, and she called 911 without delay. Time from symptom onset to first medical contact (FMC) was about 30 minutes. The ECGs EMS captured an initial 12-lead: ST elevation in III and aVF, reciprocal ST depression in aVL. Again, NOT a mystery. The medics immediately called for cath lab activation. Because of the off-hours presentation, the patient was evaluated in the ED while the team assembled. A second ECG was obtained: No changes – still bad. Since the patient was comfortable, and her condition was stable, we did an echocardiogram for education’s sake. The Echos: When a portion of the heart is ischemic, it doesn’t move very well. It’s like an area of the heart is paralyzed, and the echocardiogram can be as good as the ECG in showing ACS, and sometimes it’s better! Let’s take a look at two views of the heart moving. First,imagine you chopped the heart in two, like a loaf of bread. Since the left ventricle is shaped like a hollow tube, you would be looking at a ring of myocardium. This is the short-axis view: From my fr...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: Uncategorized Source Type: research