- HPI: 75F p/w “reflux”
- Cath: culprit lesion of a large obtuse-marginal artery successfully stented
- 3V formula score: 25.4 (>23.4 favors OMI)
- Key ECG: There is a poor R-wave progression across the precordials (transition is between V4 and V5); subtle ST-elevation in V2-V4, I, and aVL; and reciprocal ST-depression in II, III, and aVF. Additionally, using the BER vs. anterior STEMI calculator on the right side of this page, the equation value of this tracing is 25.4, greater than 23.4 (using measurements of 2.7 mm, 400 ms, and 4.4 mm, respectively). This tracing is suggestive of anterior subepicardial ischemia, almost always due to LAD occlusion.
- Link to full case @ Dr. Smith’s ECG Blog: 2014-04-18