Stemi criteria

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Stemi criteria

  1. 1. STEMI on ECG • New ST elevation at J-point in 2 contiguous leads with cut-points: • ≥ 0.2 mV in men ≥ 40 years in leads V2 - V3 • ≥ 0.25 mV in men < 40 years in leads V2 - V3 • ≥ 0.15 in women in leads V2 - V3 • ≥ 0.1 mV in all other leads • In the absence of LVH and LBBB examples of ST-elevation in MI
  2. 2. Criteria Paul Sia for diagnosing STEMI on ECG
  3. 3. 3rd Universal Definition of MI (2012)
  4. 4. STEMI on ECG • New ST elevation at J-point in 2 contiguous leads with cut-points: • ≥ 0.2 mV in men ≥ 40 years in leads V2 - V3 • ≥ 0.25 mV in men < 40 years in leads V2 - V3 • ≥ 0.15 in women in leads V2 - V3 • ≥ 0.1 mV in all other leads • In the absence of LVH and LBBB examples of ST-elevation in MI
  5. 5. General pitfalls • Beware of baseline ECG abnormalities that may obscure interpretation • LBBB • refer to Sgarbossa’s criteria • LVH • J-point elevation syndromes eg, Brugada • PE • Peri/myocarditis • Cardiomyopathy, including Takotsubo • Cocaine use • Cardiac pacing
  6. 6. STEMI location • septal • V1, V2 • inferior • II, III, aVF • reciprocal changes: I, aVL • lateral • I, aVL, V5, V6 • reciprocal changes: II, III, aVF • anterior • V3, V4 • anteroseptal • V1, V2, V3, V4 • anterolateral • I, aVL, V3, V4, V5, V6 • reciprocal changes: II, III, aVF • posterior • V7, V8, V9 • reciprocal changes: V1, V2, V3, V4
  7. 7. Anterolateral STEMI ECG 1
  8. 8. Inferior STEMI ECG 2
  9. 9. ECG 3 Inferolateral STEMI + Horizontal ST depression V1-3 + Tall R waves, upright T-waves V2-3
  10. 10. ECG 3 + posterior leads Inferior-lateral-posterior STEMI
  11. 11. References • Bax, Jeroen J., et al. "Third Universal Definition of Myocardial Infarction." Journal of the American College of Cardiology 60.16 (2012): 1581-1598.

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