ECG of the Week - 17th March 2014 - Interpretation

This is one of the older ECG's in my collection. I don't have any clinical information but it's safe to say the patient complained of chest pain.
Check out the comments on our original post here.

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Rate:

• 84

Rhythm:

• Regular
• Likely sinus 
• Baseline artefact

Axis:

• Normal

Intervals:

• QRS - Normal (100ms)
• QT - 320ms (QTc Bazette 380 ms)

Segments:

• ST Elevation 
• Leads I (1.5mm), aVL (2mm), V1(1mm), V2 (6mm), V3 (5mm), V4 (5mm), V5 (2mm)
• ST Depression leads II, III, aVF

Additional:

• T wave inversion leads III, aVF
• Q wave leads V1-2

Interpretation:

• Antero-lateral STEMI

This patient underwent thrombolysis acutely as per local policy at the time. I don't have any further clinical information on the case unfortunately.

Thrombolysis

I just thought I briefly touch on contraindications for thrombolysis in STEMI as I'm currently reading for the FACEM exam and it comes up occasionally. 
The following list is taken from the Australian Resuscitation Council Guideline 14.3 'Acute Coronary Syndromes: Reperfusion Strategy'.

Contraindications to thrombolysis in STEMI
ARC Guideline 14.3
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References / Further Reading

Life in the Fast Lane

• Anterior STEMI here
• Lateral STEMI here

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.