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Differential Diagnosis for ST Segment Elevations
 - ACUTE STEMI 
 - PULMONARY EMBOLISM 
 - LBBB
Differential Diagnosis ... for ST Segment ... Elevations - ACUTE ... EMBOLISM - LBBB ... #STElevation #STEMI
Causes of ST Segment Elevation - Differential Diagnosis Framework

STEMI:
 • Upsloping convex STE: "Pardee's sign" +
Elevation - Differential ... Diagnosis Framework ... morphology similar to LBBB ... #ST #STEMI #Segment ... #Elevation #differential
Here’s an ECG of a patient with 100% Acute LAD Occlusion

Remember that RBBB normally has ST
Remember that RBBB ... So ANY ST Elevation ... segment should ... STEMI Criteria misses ... #EKG #Electrocardiogram
Owing to the morbidity and need for urgent treatment, STEMI is the default diagnosis is patients
urgent treatment, STEMI ... patients with ST ... features of the EKG ... #EKG #ECG #STElevation ... #STSegment #Differential
STEMI Equivalents on ECG
 • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
STEMI - Elevation ... of ST segment at ... indistinguishable from ST-segment ... #EKG #diagnosis ... #differential #
Modified Sgarbossa Criteria - Diagnostic Checklist for diagnosing MI in LBBB or Pacemaker
1) Identify LBBB or
- Diagnostic Checklist ... for diagnosing ... Discordance" = ST ... - Suspect STEMI ... #Checklist #EKG
Modified Sgarbossa Criteria for diagnosing STEMI in the presence of a LBBB If there is concordant
for diagnosing ... STEMI in the presence ... changes (ST segments ... elevation of greater ... #LBBB
De Winter T Wave on ECG

Diagnostic Criteria
 - Tall, prominent, symmetric T waves in the precordial
Diagnostic Criteria ... segment depression ... segment elevation ... aVR - “Normal” STEMI ... #EKG #Clinical
Approach to ECGs - Ischemia
MI = Biomarkers + ECG or echo/angiogram findings
Pathologic Q - 1/3 height
0.5mm downgoing ST ... line; upsloping ST ... in V1, unless LBBB ... #EKG #diagnosis ... Interpretation #differential