In our study we found that symptoms of hypotension, decreased level of consciousness and raised JVP may serve as a clue to the diagnosis of RV infarct in patients of IWMI and therefore right sided
chest leads should always be used in such patients presenting with 12 hours of their symptoms.
The observation of T wave negativity in
chest leads on surface ECG after sinus rhythm suggested a possible coronary ischemia in the patient.
Respiration rate, or the number of breaths taken per minute, typically requires manually counting breaths with a timer and then converting to a rate per minute, or being fitted with
chest leads or straps that can be inconvenient.
Furthermore, in Figure 1, the
chest leads appear to have been on the right side of the chest.
Presence of ST segment elevation in
chest leads along with raised cardiac troponin-t levels (trop-t >0.3 ng/dl) was classified as STEMI.
The points on chest wall used for recording
chest leads were marked with a skin pencil, so that same points could be used serially in a given patient.
Acute myocardial infarction with isolated ST-segment elevationinposterior
chest leads V7-V9.
The
chest leads of electrocardiogram (ECG) should be reversed but not the limb leads if not the ECG tracings can erroneously display readings of intraoperative myocardial ischemia.[sup][8] Central venous catheterization if required should be inserted in the left internal jugular vein to gain direct access to the right atrium and avoid injury to the thoracic duct.
The established criteria of Myocardial Infarction which defines STEMI as new ST elevation at the J point in at least 2 contiguous leads of [greater than or equal to]2 mm (0.2 mV) in men or [greater than or equal to]1.5 mm (0.15 mV) in women in leads V2-V3 and/or of [greater than or equal to]1 mm (0.1 mV) in other contiguous
chest leads or the limb leads.
Progressively larger QRS complexes in standard
chest leads [V.sub.1] to [V.sub.5] exclude situs inversus.
Her examination showed pulse:97/min; BP: 135/81mmHg; RR:20/min; SpO2:89-92% with FiO2 at 2L/min; ECG showed normal sinus rhythm with tachycardia, T-wave inversions in lead III and V1, strain pattern in anterior
chest leads, right ventricular hypertrophy; Clubbing in both hands, mild peripheral and central cyanosis with pale complexion.
