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diagnosis ekg electrocardiogram algorithm clinical coronary endocarditis management omi acs angiogram artery cardiogenic catheterization dcsi detroit dewinter equivalent equivalents fluoroscopy
3 ECG patterns for Acute Occlusion MI (OMI) without meeting ST elevation criteria • Posterior MI
Acute Occlusion ... without meeting ST ... elevation criteria ... MyocardialInfarction #OMI #STEMI ... equivalent #diagnosis #cardiology
De Winter T Wave ECG Pattern STEMI Equivalent - Left anterior descending (LAD) occlusion 1) Upsloping
Pattern STEMI ... descending (LAD) occlusion ... 1) Upsloping ST ... #Diagnosis #Cardiology ... #Criteria
Suspected ACS - OMI vs STEMI - Differential Algorithm The name STEMI cognitively inspires EPs to fail
- Differential ... believe that the ST ... segment is the only ECG ... #Differential # ... Algorithm #cardiology
Here’s an ECG of a patient with 100% Acute LAD Occlusion Remember that RBBB normally has ST
100% Acute LAD Occlusion ... STEMI Criteria misses ... EM_RESUS #LAD #Occlusion ... #Total #ECG #EKG ... Electrocardiogram #Clinical #Cardiology
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
Left Main Coronary Artery Thrombus seen on Angiography “Mother of all coronary thrombi”. 55 year old
Anterior wall STEMI ... Cardiogenic shock, ECG ... predicted Left main occlusion ... LMCA #Angiogram #CathLab ... #clinical #cardiology
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 STEMI Equivalents on ECG • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
on ECG • Conventional ... • Sgarbossa criterion ... #Equivalents #ECG ... #differential # ... cardiology #electrocardiogram
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM INCLUSION CRITERIA Acute Myocardial Infarction  Ischemic Symptoms  EKG and/or biomarker evidence of AMI
INITIATIVE ALGORITHM INCLUSION ... CRITERIA Acute ... Ischemic Symptoms  EKG ... evidence of AMI (STEMI ... Initiative #Management #Cardiology
Endocarditis Summary Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV substance use • IV catheter • Recent
due to vascular occlusion ... Marantic (NTBE) Differential ... -> TEE • Duke Criteria ... ↑ ESR, CRP • EKG ... diagnosis #management #cardiology
Endocarditis - Overview and Differential Diagnosis Framework Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV
- Overview and Differential ... due to vascular occlusion ... → TEE • Duke Criteria ... ↑ ESR, CRP • EKG ... #Diagnosis #cardiology
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