{"id":414,"date":"2015-12-11T02:40:26","date_gmt":"2015-12-11T02:40:26","guid":{"rendered":"http:\/\/torreyekg.com\/?p=414"},"modified":"2015-12-11T02:41:38","modified_gmt":"2015-12-11T02:41:38","slug":"ekg-of-the-week-13","status":"publish","type":"post","link":"http:\/\/torreyekg.com\/index.php\/2015\/12\/11\/ekg-of-the-week-13\/","title":{"rendered":"EKG of the Week #13"},"content":{"rendered":"<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/ekg13.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-415 size-full\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/ekg13.png\" alt=\"ekg13\" width=\"647\" height=\"360\" srcset=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/ekg13.png 647w, http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/ekg13-300x167.png 300w\" sizes=\"auto, (max-width: 647px) 100vw, 647px\" \/><\/a><br \/>\nWhat do you think about this EKG of a 63-year-old man experiencing chest pain whenever he walks across the room?<\/p>\n<div class=\"spoiler-wrap\"><div class=\"spoiler-head collapsed\" title=\"Expand\">Interpretation &amp; Explanation<\/div><div class=\"spoiler-body\" style=\"display: none;\"><br \/>\nThis should be a striking EKG, and in fact should send shivers down your spine! There are significant ST-segment depressions in many leads (I, II, aVL, III, V<sub>2-6<\/sub>) as well as ST-segment elevation in aVR. This EKG is the classic example of critical left main occlusion, and should be considered a \u201cSTEMI equivalent.\u201d This patient should be referred to interventional cardiology, as this patient was! They took him to cath, and indeed found a 99% stenosis of the left main coronary artery; they inserted an IABP to support his pressure and alleviate symptoms, and got an emergent cardiac surgery consult for CABG. The surgery was accomplished and the patient did very well.\n<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/EKG-132.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-416\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/EKG-132.png\" alt=\"EKG 132\" width=\"185\" height=\"192\" \/><\/a><br \/>\nCritical occlusion of left main coronary artery.<\/p>\n<p>Wellens described this EKG finding many years ago \u2013 ST-segment depression in \u2265 8 leads and ST-segment elevation in aVR. This is particularly specific if there is also ST elevation in aVL.<\/p>\n<p>Lawner BJ, Nable JV, Mattu A. Novel patterns of ischemia and STEMI equivalents. <em>Cardiol Clin<\/em> 30:591-599, 2012.<br \/>\n<\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>What do you think about this EKG of a 63-year-old man experiencing chest pain whenever he walks across the room?<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-414","post","type-post","status-publish","format-standard","hentry","category-ekg-of-the-week"],"_links":{"self":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/414","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/comments?post=414"}],"version-history":[{"count":2,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/414\/revisions"}],"predecessor-version":[{"id":418,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/414\/revisions\/418"}],"wp:attachment":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=414"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=414"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=414"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}