The EKG strip above is indicative of STEMI: ST-segment elevated myocardial infar

Question

The EKG strip above is indicative of STEMI: ST-segment elevated myocardial infarction. Another common sign of acute MI is wide QRS complex. Research both pathological EKG signs and confirm their presence (or not) on this EKG strip. Furthermore, every EKG has universal voltage and time scale for interpretation of heart rate/period/amount of polarization etc. Again, learn how to apply this scale and answer following questions. a) What is the heart rate of this patient? b) Is the heart in a normal sinus rhythm? c) What part of heart is affected? d) Design a new method to diagnose the condition depicted above. I would like to see original bioengineering approach.

Explanation / Answer

a. Since the QRS complexes are irregular, the heart rate can be determined by the number of QRS complexes in 19sec time period and multiply it by 6. In the figure given above, it is 15 QRS complexes in a period of 10sec. Thus heart rate is 15×6=90.

b. Normal sinus rhythm is characterized by presence of correctly oriented P waves. P waves should be round, all P waves should be of same shape and should be present before every QRS complex. But in the figure given above, P wave is not regular, neither are they round or equal in all consequitive QRS. Thus it does not follow normal sinus rhythm.

c. This EKG has an enlarged R wave which indicates enlarged ventricles. Also T wave is flatter which indicates heart muscle receiving insufficient oxygen.

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