Original chalk talk by Brandon Fainstad, MD
Edits and graphics by Yilin Zhang, MD
- Review coronary anatomy and associated distributions on an ECG
- Practice cases with pearls and pitfalls
Coronary anatomy, vessel distribution and associated leads on an ECG
Fill in the coronary anatomy:
- Right coronary artery (RCA)
- Posterior descending artery (PDA)
- Left main artery
- Left anterior descending (LAD)
- Circumflex artery
For additional points:
- R marginal artery
- L marginal artery
- Diagonal branch of the LAD
Practice cases with pearls and pitfalls
Is this a STEMI? What is the distribution?
What is the next step in evaluating this MI and why?
What is the best explanation(s) for these ST changes?
1. Diffuse ST-elevations and PR-depressions along with ST-depressions and PR-elevation in aVR = peri-myocarditis.
2. Diffuse ST-elevations w/ ST-depressions in aVR = possible left main occlusion.
Is there evidence of new or old infarct on this ECG? If so, what distribution?
Nathanson LA, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: Self-Assessment Program for Students and Clinicians. http://ecg.bidmc.harvard.edu.