PODCAST: The Ischemic EKG Deep Dive

פוסט זה זמין גם ב: עברית

Podcast: Play in new window | Download

The 6 STEMI Equivalents:

1. Posterior MI
   • ST Depression V2/V3 (or STE in V7-V9)
2. Right Ventricular MI
   • STE V1 associated with inferior MI ; or STE V4R-V6R
3. Wellens Syndrome
   • Type A: Biphasic T-waves V2/3
   • Type B: Deep Symmetric T-wave Inversion V2/V3
4. De Winter’s T Wave
   • ST Depression with a large, symmetric, upright T wave
5. STE avR with diffuse ST-Depression
   • Usually a strain pattern due to underlying pathology, in correct clinical context can represent a left main or proximal LAD coronary occlusion
6. Modified Sgarbossa Criteria in LBBB
   • Concordant STE in any lead
   • Concordant ST Depression in V1-V3
   • Excessive Discordance (ST/S ratio >0.25)

Other atypical ischemic EKG findings:

1. Isolated TWI in avL – early sign of inferior MI
2. Hyperacute TWave
3. NTTV1 (New Tall T-wave in V1)

Further Reading (see photos in the article):

ECG Diagnosis of Life-Threatening STEMI Equivalent’s: Journal of the American College of Cardiology