March 11, 2017

Inferior Wall MI

Image 1 - ECG case

A 70 yo with h/o DM and HTN was admitted due to dizziness and syncope while having breakfast. Pt regained consciousness a few moments later and brought to local hospital. Patient was not in distress and only had mild chest discomfort with the ff VS afebrile RR 18 PR 84 BP 140/80 sat 100 NC. Trop less than 0.03, lytes and crea in the normal range.

Image 2 - ECG case marked

ECG shows sinus tachycardia with STE II, III and aVF (III >II), STD's aVL,I and in precordial leads up to V3 and multifocal PVC's. This indicates inferior wall MI (STEMI).

Heart cath revealed occlusion in the distal RCA and intervention was done. Echo showed mild LVH and EF in the 60's.

Patient was discharged after a few days.

You might ask what could have caused the syncope. It was thought that the pt might have VT but that was not observed in the hospital stay.


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