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Three months prior to this presentation, he received a pacemaker for severe bradycardia and syncope due to sinus node dysfunction. The ED provider ordered a coronary CT scan to assess the patient for CAD. His EKG with worse pain now shows enough ST elevation to meet STEMI criteria. This EKG seems to lack it.
Ct coronaryangiogram showed normal coronary arteries. Smith note: I think CT coronaryangiogram is reasonable with the elevated troponins and symptoms. Anterior STEMI? This gradual change in P wave morphology as the heart rate varies could be consistent with a wandering atrial pacemaker. What is it?
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