Scenario: This is a routine postoperative 12-lead ECG waveform. The patient is an 85-year-old white woman who has been admitted to the cardiothoracic intensive care unit (ICU) after undergoing abdominal aortic aneurysm repair. In following with the cardiothoracic ICU’s critical care pathway, the patient should be aroused and extubated within the next 4 hours.

Interpretation: Normal sinus rhythm at 70 beats per minute with an acute inferior lateral myocardial infarction (MI) with evolving T-wave changes.

Octogenarian status (age >80 years old) no longer precludes f it patients from aggressive surgeries, including abdominal aortic aneurysm repair. However, the rate of perioperative infarction is significant in this population. Given that cardiac monitoring is the standard of care in the ICU, postoperative complications related to the cardiovascular system can be detected quickly. In this 12-lead ECG waveform, although the ST deviation is not 2 mm, there is at least 1 mm of ST...

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