Scenario
A 40 year old man presents to the emergency department with a history of chest pain two hours previously. He is now pain free.
Question
a. Describe and interpret her ECG (50%) b. What investigations does this man need and why? (50%)
Answer
FACEM VAQ Exam 2005.2 – Question 7
- Overall pass rate for this question was 36/56 (64.3%).
- The ECG provided shows a change from broad to narrow complex rhythm across the ECG and ST/T changes suggesting a proximal LAD stenosis.
- The key to this question was to recognize ECG changes strongly indicative of a proximal left coronary stenosis which was visible in the second half of the ECG when the broad complex rhythm was no longer present.
- Candidates who failed did not appreciate the clinical significance of the ECG changes and the presumed site of stenosis, and therefore did not make clear the need for early angiography.
About Mike Cadogan
