Normal findings
- • Normal ECG with normal echo and CXR is reassuring
Common abnormal findings
Anterior STEMI
- • ST elevation V1-V4 ↔ LAD territory on echo (anterior wall RWMA)
PE
- • S1Q3T3, RBBB, T inversion V1-V4 ↔ CTPA filling defect, RV dilatation on echo
Pericardial effusion
- • Low voltage / electrical alternans ↔ effusion on echo / globular heart on CXR
Interpretation tips
- • Always correlate dynamic ECG changes with bedside echo before angiogram
- • Right-sided leads for inferior MI to exclude RV infarct
Clinical correlation
- • Ischaemic pattern + RWMA + raised troponin = ACS
- • Strain pattern + dilated RV = PE
Common mistakes
- • Treating PE as ACS or vice-versa without imaging
Educational support only — not a substitute for clinical judgment.
