Management of the Medical Patient in Remote & Rural Location

ECG 3

There are certain features on an ECG that you should look for if you suspected and MI:

• New left bundle branch block
• ST Elevation
• ST depression in 2 or more of leads V1-V4 (posterior MI)
• Reciprocal ST depression
• Hyperacute tall T waves
• Q waves (occur hours to days after a cardiac event and suggest ischaemic cardiac muscle wall damage has occurred)

Remember ST elevation needs to be >2mm on chest leads and >1mm on limb leads to be classed as a STEMI

Once an initial ECG has been taken, the ECG leads should be left in place to help with comparison for subsequent ECGs.

Remember initial ECGs can be normal in patients having an MI. Therefore, is your clinical suspicion is high the patient should be admitted and serial ECGs should be obtained every 5-10 mins to look for abnormal changes.