Anterior wall myocardial infarction

A 42-years old male came in the emergency with chief complaints of acute onset retrosternal chest pain of 2 hours duration along with palpitation, perspiration,dizziness and dyspnoea. Patient was a known case of hypertension since last 5 years, chronic smoker, used to smoke around 2-3 packet of cigarettes  per day since last 20 years. During evaluation in the emergency patient blood pressure was 110/70 mmhg, pulse rate was 94 beats per minute. On examination of the chest patient bilateral normal vesicular sound heard and there were no added sound. Patient ECG done in the emergency is shown below

ECG 1

ECG is showing normal sinus rhythm at around 94 beats per minute, Left axis deviation, there is ST segment elevation seen in lead V1-V5, also mild ST segment elevation seen in lead V6, and also minimal ST elevation in lead 1, avL, there is ST segment depression seen in lead III, avF so the ECG of the patient is suggestive of extensive acute anterior wall myocardial infarction.

ECG 2 

Another ecg of the same patient is showing marked ST segment elevation in lead V1-V6, also very mild ST segment elevation also seen in lead I, avL, there are reciprocal changes in the form of ST segment depression seen in lead III, avF so the final diagnosis of the ECG is Acute ST elevation anterior wall myocardial infarction.

Patient was immediately started on injection streptokinase thrombolytic therapy. Patient ECG done 6 hours after thrombolysis is shown below.

  ECG 3

ECG is showing marked ST segment resolution in lead V1-V6 which is more than 50% suggestive of successful thrombolysis.

So the final diagnosis is Acute ST segment elevation anterior wall myocardial infarction with successful thrombolysis.


Thank you,
Dr Praveen Gupta