Medical Surgical EKG #13

Question

A client arrived at the Emergency Room complaining of heaviness in the chest for the past hour. The nurse placed the client on a heart monitor and immediately alerted the physician of the following electrocardiogram (ECG) reading:


The nurse interprets the finding as abnormal according to the following ECG characteristics:

Answers

  1. Premature ventricular contractions are present
    • Rationale:

      This answer is not correct because premature ventricular contractions (PVCs) are abnormal, additional heartbeats that disrupt the regular heart rhythm. The abnormal heartbeat begins in the ventricle and causes a contraction to occur prematurely, which is reflected in a widened QRS complex. ST elevation is noted on this ECG strip which, added to the client complaint of heaviness in the chest, likely indicates a STEMI.

  2. ST segment elevation is present
    • Rationale:

      This answer is correct because ST elevation is noted on this ECG strip which, added to the client complaint of heaviness in the chest, indicates a STEMI and occurs when one or more cardiac arteries are blocked. The blockage will halt supply of oxygen rich blood to the affected area in the heart, which may cause permanent injury and even death.

  3. Atrial fibrillation is present
    • Rationale:

      This answer is not correct because in atrial fibrillation, the rhythm is irregular, the atrial rate is 300 to 600 bpm with the ventricular rate between 120 to 200 bpm. ST elevation is noted on this ECG strip which, added to the client complaint of heaviness in the chest, indicates a STEMI and occurs when one or more cardiac arteries are blocked. The blockage will halt supply of oxygen rich blood to the affected area in the heart, which may cause permanent injury and even death.

  4. U waves are present
    • Rationale:

      This answer is not correct because a U wave is a small dip or deflection just following the T wave in an ECG strip. ST elevation is noted on this ECG strip which, added to the client complaint of heaviness in the chest, indicates a STEMI and occurs when one or more cardiac arteries are blocked. The blockage will halt supply of oxygen rich blood to the affected area in the heart, which may cause permanent injury and even death.

Overview

ST-elevation in the ECG strip along with complaints of heaviness in the chest for the past hour is called ST-elevation myocardial infarction (STEMI). Identification of this life-threatening ECG rhythm is essential and should be reported immediately to the healthcare provider.

Explanation

Learning Outcomes

Identifying an acute myocardial infarction is important in ECG interpretation and should be reported immediately to the healthcare provider. ST segment elevation along with symptomatic complaints of chest pain is also called ST-Elevation Myocardial Infarction (STEMI) and occurs when one or more cardiac arteries are blocked. The blockage will halt supply of oxygen rich blood to the affected area in the heart, which may cause permanent injury and even death.

Test Taking Tip

Recognizing or missing an ST elevation can mean the difference between life or death. Learn ECG normal and abnormal findings.

Video Rationale