And, I mean really basics. We don’t spend much time talking about EKG reading in my Pathophysiology class because my own background is limited. However, I have asked that students be able to identify a normal EKG vs a ST elevated EKG; which signifies, along with other signs, such as cardiac enzymes in the blood; that a patient has had a heart attack.

(by the way, I would like to say right up front, that I happily accept comments that can improve this post)

Case Report:

A patient (65 yo male Caucasian) arrives in the ER after having severe chest pain radiating into the left arm, neck and jaw. The patient has a history of hypertension, some atherosclerosis, and spasms of the coronary arteries. Patient smokes 1/2 pack per day, and drinks approximately 1-2 beers a day. When symptoms set in, he took a Nitroglycerine tab under his tongue, but experienced no relief. His wife drove him in to the ER as he was experiencing nausea.

A blood test for cardiac proteins indicated that Troponins (Tn T and Tn I) were both present in serum at 10x the upper reference limits. His EKG appear as:

Click image for live EKG

What is your diagnosis?

What do the elevated Troponins indicate?