16 results
Here’s an ECG of a patient with 100% Acute LAD Occlusion

Remember that RBBB normally has ST
patient with 100% Acute ... LAD Occlusion ... normally has ST Depression ... STEMI Criteria misses ... - Sam Ghali, M.D
De Winter T Wave ECG Pattern 
STEMI Equivalent - Left anterior descending (LAD) occlusion 

1) Upsloping
Pattern STEMI ... anterior descending (LAD ... 1 mm) 2) ST depressions ... #EKG #Electrocardiogram ... Diagnosis #Cardiology #Criteria
Approach to ECGs - Ischemia
MI = Biomarkers + ECG or echo/angiogram findings
Pathologic Q - 1/3 height
women • DDx: Acute ... have no pain - LAD ... avR - proximal LAD ... disease - ST depression ... #EKG #diagnosis
Mid Left Circumflex STEMI on ECG

This patient who had cp for 1 hour had a 100%
STEMI on ECG ... reciprocal st depressions ... frequently missed stemi ... #Circumflex #STEMI ... #ECG #EKG #Electrocardiogram
STEMI Equivalents on ECG
 • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
• Sgarbossa criterion ... V6 • Sgarbossa criterion ... • Sgarbossa criterion ... deviation) • Acute ... #EKG #diagnosis
High Lateral STEMI - D1 of LAD

There is transmural injury isolated to I & aVL. These
High Lateral STEMI ... similar but this ST Depression ... - Sam Ghali, M.D ... @EM_RESUS #STEMI ... #EKG #Electrocardiogram
Modified Sgarbossa Criteria - Diagnostic Checklist for diagnosing MI in LBBB or Pacemaker
1) Identify LBBB or
Modified Sgarbossa Criteria ... - Fusion: odd ... - Suspect STEMI ... > 1 mm in any lead ... Diagnosis #Checklist #EKG
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM

INCLUSION CRITERIA
Acute Myocardial Infarction
 Ischemic Symptoms
 EKG and/or biomarker evidence of AMI
ALGORITHM INCLUSION CRITERIA ... Acute Myocardial ... Ischemic Symptoms  EKG ... ACTIVATE CATH LAB ... DCSI #Initiative #Management
SSRI Initiation
How long before increasing dose?
 • 4 wks. Initial response in 2-4 wks, max response
Depression: 50% ... 50% reduction in GAD ... before starting new med ... #psychiatry #treatment ... #management
Acute and Chronic Causes of Dyspnea - Differential Diagnosis
Pulmonary/Chest Wall:
 • Acute: Trauma, COPD exacerbation, Asthma
Pericarditis, CAD ... Neuromuscular disease (eg ... Metabolic acidosis (eg ... Thyroid disease Psychiatric ... Anxiety, PTSD, Depression