11 results
De Winter T Wave ECG Pattern 
STEMI Equivalent - Left anterior descending (LAD) occlusion 

1) Upsloping
Pattern STEMI ... anterior descending (LAD ... DeWinter #TWaves #ECG ... #Diagnosis #Cardiology ... #Criteria
Inpatient Cath Lab Indications
Cath Lab ASAP:
STEMI
NSTEMI:
1. Unstable/cardiogenic shock
2. Severe LV dysfunction or
3. Recurrent/persistent rest angina despite
low (1-2) risk, +ECG ... /UA: stable, TIMI ... #Inpatient #CathLab ... #Indications #Cardiac ... catheterization #cardiology
Here’s an ECG of a patient with 100% Acute LAD Occlusion

Remember that RBBB normally has ST
with 100% Acute LAD ... STEMI Criteria misses ... @EM_RESUS #LAD ... Occlusion #Total #ECG ... #Clinical #Cardiology
Modified Sgarbossa Criteria - Diagnostic Checklist for diagnosing MI in LBBB or Pacemaker
1) Identify LBBB or
Modified Sgarbossa ... Discordance" = ST ... - Suspect STEMI ... electrocardiogram #ecg ... #cardiology #lbbb
Modified Sgarbossa Positive ECG

Interestingly, the ECG for this case report shows development of conventional STEMI criteria
of conventional STEMI ... complex 10 in lead ... V6 has ST elevation ... #Modified #EKG ... Electrocardiogram #Clinical #Cardiology
STEMI Equivalents on ECG
 • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
on ECG • Conventional ... • Sgarbossa criterion ... 3 (modified) - ... #Equivalents #ECG ... #differential #cardiology
Wraparound LAD STEMI on Cardiac Cath
47 year old with chest pain. Ectopic atrial rhythm with ST
Wraparound LAD STEMI ... on Cardiac Cath ... atrial rhythm with ST ... #cardiology #CardiacCath ... #CathLab #fluoroscopy
Left Main Coronary Artery Thrombus seen on Angiography

“Mother of all coronary thrombi”.  55 year old
Anterior wall STEMI ... Cardiogenic shock, ECG ... established, but died on table ... LMCA #Angiogram #CathLab ... #clinical #cardiology
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM

INCLUSION CRITERIA
Acute Myocardial Infarction
 Ischemic Symptoms
 EKG and/or biomarker evidence of AMI
ALGORITHM INCLUSION CRITERIA ... Ischemic Symptoms  EKG ... evidence of AMI (STEMI ... ACTIVATE CATH LAB ... Initiative #Management #Cardiology
Modified Sgarbossa Criteria for diagnosing STEMI in the presence of a LBBB If there is concordant
Modified Sgarbossa ... Criteria for diagnosing ... STEMI in the presence ... ≥ 1mm (in any lead ... S #Diagnosis #Cardiology