A 29 years old male who had the history of acute onset retrosternal chest pain of two hours duration, went to outside hospital. The patient had the history of recently diagnosed diabetes mellitus and family history of coronary artery diseases.
ECG of the patient is shown below
ECG is showing sinus tachycardia with a heart rate around 130 beats per minute, normal axis, PR interval of 160 msec, there is marked ST-segment elevation seen in lead V2-V6, I, avL, II, III, avF, QT interval of 320 msec suggestive of extensive anterior wall myocardial infarction.
Patient was immediately thrombolysed. ECHO suggestive of severe left ventricular systolic dysfunction. Post thrombolysis coronary angiogram of the patient showed mid LAD Total occlusion. PCI with stenting to LAD done. Post PCI patient develops acute onset episode of palpitations and giddiness.
ECG of the patient after stenting
ECG is showing sine wave pattern with no clearly seen QRS complex or P wave or ST segment or T wave. Heart rate around 300 beats per minute so the ECG is suggestive of ventricular flutter.
Another ECG of the patient
ECG is showing ventricular flutter. The patient develops hypotension. The patient was immediately given DC shock, injection amiodarone, and CPR but he could not be revived and he died due to cardiac arrest.
Thank you
Praveen Gupta
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