ACS - ECG: Difference between revisions

Revision as of 04:47, 25 February 2015

Anterior STEMI
- Reciprocal ST-segment depression in at least one of leads II, III, aVF
- Occurs in 40-70% of cases
Inferior STEMI
- Reciprocal ST-segment depression usually present in I, aVL; often in V1-V3
- Occurs in 56% of cases
Posterior STEMI
- Reciprocal ST-segment depression in V1-V4
  - Differentiate from inf STEMI reciprocal depression based on upright T waves, posterior leads showing STEMI
- Often associated w/ ST-segment elevation in II, III, aVF (inferior involvement)

Authors:

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 == ST Segment Elevation  ==
-*Stage 1
-**Timing: 30min - hours
-**Finding: hyperacute T waves
-***&gt;6mm limb leads
-***&gt;10mm precordial leads
-**Duration: normalizes in days, weeks, or months
-*Stage 2
-**Timing: minutes - hours
-**Finding: ST segment elevation
-***≥0.1mV in two or more contiguous leads
-**Duration: ST segment resolution occurs over 72hrs; completely resolves w/in 2-3wks
-*Stage 3
-**Timing: within 1hr; completed within 8-12hr
-**Finding: Q waves
-**Duration: persist indefinitely in 70% of cases
-[[Image:STEMI Progression.jpg]]
-*a: 30min after chest pain onset
-*b: 45min after chest pain onset (hyperacute T waves)
-*c: 70min after chest pain onset (ST elevation)
-*d: 3hr after PCI (ST segment has decreased, TWI incdicates reperfusion)
-*e: 5 days after PCI (ST segment back to baseline, TWI is near baseline)
 == Reciprocal Changes  ==