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ECG Exercise 6 - OMI
ECG Exercise 6 - OMI

ECG Exercise 6 - OMI

Last updated 9/19/24

Is there an occluded coronary artery causing an acute myocardial infraction?

Assume every patient is presenting with chest pain unless told otherwise.

Click on ECG to zoom in (for computer only)

ECG 1

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1024

ECG 2

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1025

ECG 3

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1026

ECG 4A

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?

ECG 4B - Repeat ECG

image
‣
OMI?
‣
Source: ECG 1027

ECG 5

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1028

ECG 6

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1029

ECG 7

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1030

ECG 8

image

Additional info: ECG taken after cardiac arrest with ROSC

‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1031

Let’s take a break.

‣
What’s your differential diagnosis for AVR STE with diffuse ST depressions?

ECG 9

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1032

ECG 10

image

Additional history: heavy smoker presenting with on and off chest pain for 2 days.

‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1033

ECG 11

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1034

ECG 12

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1035

ECG 13

image

Additional history: recent MI& PCI/stent (non-compliant with meds) presenting with chest pain.

‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1036

ECG 14

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1037

ECG 15

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
Previous ECG from a year ago.
‣
OMI?
‣
Source: ECG 1038

ECG 16

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1039

ECG 17

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1040

ECG 18

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1041

ECG 19

image
‣
Same ECG but 5 seconds per lead
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1042

ECG 20

image

Additional info: Patient had 2 days of chest pain that resolved at ED arrival.

‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1043

ECG 21

image
‣
Estimate the heart rate (slow, fast or normal), rhythm, and axis to the nearest quadrant.
‣
Any concerning intervals, QRS morphology, ST segments or T waves?
‣
OMI?
‣
Source: ECG 1044

This post is for education and not medical advice.

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