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cardiology ekg ecg electrocardiogram clinical diagnosis twaves differential criteria em equivalents ischemia lbbb modified occlusion sgarbossa stelevation wraparound acutepericarditis acutestemi
De Winter T Wave ECG Pattern STEMI Equivalent - Left anterior descending (LAD) occlusion 1) Upsloping
De Winter T Wave ... ECG Pattern STEMI ... anterior descending (LAD ... ) Upsloping ST elevation ... precordial leads #DeWinter
De Winter T-Waves on EKG - Anterior OMI - 2% of left anterior descending occlusions -
De Winter T-Waves ... occlusions - De Winter ... before or after STEMI ... - look for ST elevation ... Team @FOAMfrat #DeWinter
Liver Function Test (LFTs) Elevation AST - Cardiac and skeletal muscle, kidney, brain ALT - More specific for
Function Test (LFTs) Elevation ... SinaiBmoreIMRes #Liver #FunctionTest ... #LFTs #Elevation
Approach to ECGs - Ischemia MI = Biomarkers + ECG or echo/angiogram findings Pathologic Q - 1/3 height
bigger than QRS - deWinter ... have no pain - LAD ... avR - proximal LAD ... infarct, get a 15 lead ... electrocardiogram #cardiology #STEMI
De Winter T Wave on ECG Diagnostic Criteria - Tall, prominent, symmetric T waves in the precordial
Absence of ST elevation ... - ST segment elevation ... aVR - “Normal” STEMI ... or follow the deWinter ... pattern #DeWinter
Here’s an ECG of a patient with 100% Acute LAD Occlusion Remember that RBBB normally has ST
with 100% Acute LAD ... So ANY ST Elevation ... have ’relative elevation ... STEMI Criteria misses ... @EM_RESUS #LAD
STEMI Equivalents on ECG • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
STEMI Equivalents ... • Conventional STEMI ... J point • De Winter ... aVR • Posterior STEMI ... anterior leads) #STEMI
LAD IWMI LAHB RAD [PHB RVH Lateral wall infarct Lead reversal Dextrocardia Wide ORS RBBB - terminal delay [BBB IVED WPW = delta wave Hyperkalemia Type l antiarrhythmic drugs Pacemaker ST elevation Early repolarization
LAD IWMI LAHB ... Pacemaker ST elevation ... pericarditis Elevation ... AcutE STEMI Variant ... Nonconducted APC #LAD
ECGofTheDay - What is the most likely diagnosis? What is this finding called? ... The combination of
referred to as the De Winter ... in 2% of acute LAD ... be considered a STEMI ... Cardiology #EKG #ECG #DeWinters
Causes of ST Segment Elevation - Differential Diagnosis Framework STEMI: • Upsloping convex STE: "Pardee's sign" +
of ST Segment Elevation ... Diagnosis Framework STEMI ... ventricle pacing lead ... • ST-segment elevation ... #ST #STEMI #Segment
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