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diagnosis ekg clinical differential electrocardiogram algorithm angiogram artery cardiac catheterization coronary dcsi definition detroit evaluation fluoroscopy indications infarction inferoposterior initiative
Inpatient Cath Lab Indications Cath Lab ASAP: STEMI NSTEMI: 1. Unstable/cardiogenic shock 2. Severe LV dysfunction or 3. Recurrent/persistent rest angina despite
Unstable/cardiogenic ... lab w/in 24 h: NSTEMI ... low (1-2) risk, +ECG ... #Inpatient #CathLab ... catheterization #cardiology
Approach to ECGs - Ischemia MI = Biomarkers + ECG or echo/angiogram findings Pathologic Q - 1/3 height
new/old infarct STEMI ... • DDx: Acute STEMI ... diffuse PR dep) NSTEMI ... big R or R/S>I STEMI ... #STEMI #Equivalents
Left Main Coronary Artery Thrombus seen on Angiography “Mother of all coronary thrombi”. 55 year old
Anterior wall STEMI ... , in Cardiogenic ... shock, ECG predicted ... LMCA #Angiogram #CathLab ... #clinical #cardiology
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 DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM INCLUSION CRITERIA Acute Myocardial Infarction  Ischemic Symptoms  EKG and/or biomarker evidence of AMI
Infarction  Ischemic ... Symptoms  EKG ... evidence of AMI (STEMI ... or NSTEMI) Cardiogenic ... Initiative #Management #Cardiology
STEMI Equivalents on ECG • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
STEMI Equivalents ... STEMI - Elevation ... aVR • Posterior STEMI ... anterior leads) #STEMI ... #Equivalents #ECG
ECG of a 55-year-old man who presented to the ER with chest pain Computer interpretation: “Nonspecific
ECG of a 55-year-old ... to the ER with chest ... InferoPosterior transmural ischemia ... #Clinical #Cardiology ... #EKG #STEMI #InferoPosterior
Differentiating type-I vs. type-II MI Sorting this out is difficult, often relying heavily on clinical judgement. A key
of myocardial ischemia ... give someone 500 mcg ... The table below ... Type2 #Definition #NSTEMI ... #Comparison #Table
Preoperative Risk Evaluation Major Pre-Op Questions: 1. Does the patient have any modifiable risk factors that could be
Highest metabolic equivalent ... history of: a) Ischemic ... Obtain EKG if: ... one post op Cardiology ... change CV risk Chest
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