ECG Blog #547 — What Happened When? — EXTRA COPY —

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 The ECG in Figure-1 was obtained from a mid-30s man — who presented with CP (Chest Pain) that began ~1 hour earlier.

• The patient had some risk factors — but no known history of heart disease.
• He reports a similar episode about a week earlier. He did not seek care at that time — because the episode resolved spontaneously. 

QUESTIONS:

• In view of the above history — How would YOU interpret the ECG in Figure-1?
• What happened when?
• Culprit artery?

Figure-1: The ECG in today's case. (To improve visualization — I've digitized the original ECG using PMcardio).

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Figure-2: I've labeled today's ECG. What do you see?

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Cath Findings:

• Left-dominant coronary system.
• 100% proximal LAD occlusion.
• 80% distal LCx stenosis.
• 95% left PDA stenosis.

Cath Intervention:

• Aggrastat (Tirofiban) bolus administered.
• Proximal LAD — Thrombectomy performed; PCI with drug-eluting stent.
• Distal LCx/Left PDA — PCI performed with drug-eluting stent.
• Post-procedure Ejection Fraction preserved!

 

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Acknowledgment: My appreciation for the anonymous contribution of today's case. 

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Jennifer Carlquist — FB Messenger (8-19-2026)

 “What happened when?” — 

To be ANONYMOUS ¡!!!!!! —

 

THE CASE:

Hi! David said this is also a precordial swirl The case is a 36 yo male with cp x 1 hour. Hx: pre dm He had unrealized fh and his cath showed lad circ

Always great to converse with you… Here is the info. I hope that’s enough.

MY REPLY (Jennifer sent me a pdf with the history! )

Hi Jennifer. YES — That is plenty. Was it you (or a colleague) who presented this case? How would you like me to acknowledge you? — Your name, city and state? by yourself and/or with a colleague's name — or anonymous? (and if anonymous — I could list the city & state if you wanted — JUST LET ME KNOW.

This should be a nice case. I'll aim for sometime within the next 4-6 weeks or so, depending ... and regardless of how you want to be acknowledged — I'll let you know when the case is published! THANKS — :)