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September 2005 EKG case A 45 year old previously healthy male has 30 minutes of shortness of breath associated with chest tightness. He has a history of hypertension. There is no relief after 2 sublingual nitroglycerins given by EMS. What does the EKG show? Rate: 96 Rhythm: sinus Axis: normal QRS: Q in V1 and V2, poor R wave progression, low voltage ST: ST elevation in V1 and V2, ST depression in III and AVF with biphasic T waves EKG Diagnosis: Anterior ST elevation MI with reciprocal changes Clinical Diagnosis: Anterior wall MI Treatment: Oxygen, Aspirin, Nitrates, Beta blockers, thrombolytics vs angioplasty and stent vs CABG, monitoring |