ECG cases is a monthly blog by Jesse McLaren (@ECGcases), a Toronto emergency physician with an interest in emergency cardiology quality improvement and education. Each post features a number of ECGs related to a particular theme or diagnosis (with a focus on acute coronary occlusion), so you can test your interpretation skills. We challenge you with missed or delayed diagnosis, those with false positive diagnosis, and those that had a rapid and correct diagnosis. Cases are followed by a quick summary of the literature that relates to the cases, and we bring it home with practice changing pearls that you can use on your next shift.
ECG Cases 56 – Art of Occlusion MI Part 4: Sequence Photos
In this month's ECG Cases Dr. McLaren explores how sequence photos help identify Occlusion MI. He illustrates through cases how hyperacute T waves and subtle ST elevation with reciprocal ST depression can provide an early snapshot of occlusion MI – and might remain the only sign of occlusion. How resolution of ischemic symptoms along with regional T wave inversion (or reciprocally tall anterior T waves) can indicate spontaneous reperfusion, while subacute and persisting symptoms with Q waves and T wave inversion indicate refractory occlusion. And how spontaneous reperfusion is at risk for reocclusion, with recurrence of ischemic symptoms accompanied by ST/T pseudonormalization and then hyperacute T waves and ST elevation.
