Diagnosis of acute myocardial infarct with ventricular paced rhythm.

Management of acute myocardial ischaemia is dependent upon interpretation of the 12-lead electrocardiogram. The presence of ventricular pacing and acute myocardial infarction makes electrocardiogram interpretation difficult. This may impact upon patient management if treating staff are unaware of the expected electrocardiogram morphology or do not have a rapidly available means to make the diagnosis. This case highlights the difficulty with diagnosis of acute myocardial infarction in the presence of ventricular paced rhythm and demonstrates the electrocardiogram changes that occur with myocardial infarction.