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The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. ECG of pneumopericardium and probable myocardial contusion shows typical pericarditis Male in 30's, 2 days after Motor Vehicle Collsion, complains of Chest Pain and Dyspnea Head On Motor Vehicle Collision. ST depression.
In terms of ischemia, there is both a signal of subendocardial ischemia (STD max in V5-V6 with reciprocal STE in aVR) AND a signal of transmural infarction of the inferior wall with Q wave and STE in lead III with reciprocal STD in I and aVL. The rhythm is atrial fibrillation. The QRS complex is within normal limits.
Doesn't this necessarily mean that he was having ischemia? He was admitted for monitoring and had no dysrhythmias. What does the Queen of Hearts think? Unfortunately, life is not so simple. I recognize this as a normal variant. Amazingly, the Queen also recognizes it as "Not OMI". She is very good. The first troponin was < 3 ng/L.
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