Describe and interpret this ECG.
Atrial = 79 min-1
Ventricular = 79 min-1
First degree atrioventricular block
Duration = 80 ms
Amplitude = 0.1 mV
Duration = 204 ms
Morphology = normal
Duration = 106 ms
Axis = 45°
R wave progression:
LV Hypertrophy [Sokolow; SV1 + (RV5 or RV6) > 35mm) or RI + SIII > 25mm]?
RV Hypertrophy [R/S ratio V5 or V6 < 1 or R/S ratio V1 > 1 or S1S2S3 pattern]?
Duration = 100 ms
Morphology = elevation I, aVL, V1-5; depression III, aVF
Duration = 160 ms
Morphology = hyperacute I, aVL, V2-5; inverted II, aVF
QT duration = 416 ms
QTc duration = 479
Interpretation: There is borderline ST elevation with hyperacute T waves in the anterolateral leads (I, aVL, V2-5) and reciprocal ST depression and T wave inversion inferiorly (III, aVF). This is consistent with an acute occlusion of a dominant LAD artery. This patient presented with chest pain, onset 20 minutes prior. The patient should be sent for emergent percutaneous coronary intervention.