IWMI with PWMI

A 60 years old male, chronic smoker, hypertensive came to JIPMER emergency department with  the history of acute onset retrosternal chest pain. ECG done at the time of arrival at the emergency department is shown below

ECG 1

ECG 1 with marking

Description of the ECG-Sinus rhythm at rate around 50 per minute, normal axis, ST elevation in lead II, III,avF, ST segment depression in lead V1-V5

Diagnosis Acute inferior wall myocardial infarction

Posterior lead ECG 2 , Lead V4-V6 in the given below ECG are representing posterior lead ECG (V7,V8,V9)

Posterior lead ECG 2 with marking 

Description of the ECG-Sinus rhythm at rate 50 per minute, normal axis, ST elevation in lead V4-V6 in the posterior lead ECG suggestive of posterior wall myocardial infarction

Patient was started on streptokinase thrombolysis and post thrombolysis ECG is shown below

ECG after thrombolysis 3 

Description of the ECG-Resolution of the ST elevation in lead II,III, avF suggestive of successful thrombolysis 

Patient underwent Coronary angiography which showed Osteo proximal right coronary artery long lesion with approximately 80-90% stenosis.

Coronary angiography of the patient-Show osteo-proximal stenosis of Right  coronary artery