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September EKG 2006 Answer Key

This is a 72 year old male with complaints of sudden onset (2 hours ago) of pressure like chest pain associated with nausea, diaphoresis, and radiation to the left arm. He has a PMH of CHF, HTN, MI, DM, and hemorrhagic CVA.  This is his EKG.

What does the EKG show and what is your diagnosis?

Rate:  56

Rhythm:  sinus bradycardia

Axis:  left

PR:  normal

QRS:   normal

ST: elevated in I, aVL, V1-V6, with reciprocal ST depression in III and aVF

  • EKG diagnosis: Acute anterolateral MI, sinus bradycardia with left atrial enlargement and LVH
  • Treatment: ASA, morphine, nitroglycerin, Beta blockers (Hold with HR< 60), oxygen, Cardiac cath lab (this patient is excluded from thrombolytics secondary to his history of hemorrhagic CVA).

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