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An ST elevation is considered significant if the vertical distance inside the ECG trace and the baseline at a point 0.04 seconds after the J-point is at least 0.1 mV (usually representing 1 mm or 1 small square) in a limb lead or 0.2 mV (2 mm or 2 small squares) in a precordial lead. [2]
ST elevation ≥1 mm in a lead with a positive QRS complex (i.e.: concordance) - 5 points; concordant ST depression ≥1 mm in lead V1, V2, or V3 - 3 points; ST elevation ≥5 mm in a lead with a negative (discordant) QRS complex - 2 points; ≥3 points = 90% specificity of STEMI (sensitivity of 36%) [2]
ST elevation may indicate transmural myocardial infarction. An elevation of >1mm and longer than 80 milliseconds following the J-point . This measure has a false positive rate of 15-20% (which is slightly higher in women than men) and a false negative rate of 20–30%.
The 2018 European Society of Cardiology/American College of Cardiology Foundation/American Heart Association/World Health Federation Universal Definition of Myocardial Infarction for the ECG diagnosis of the ST segment elevation type of acute myocardial infarction require new ST elevation at J point of at least 1mm (0.1 mV) in two contiguous leads with the cut-points: ≥1 mm in all leads ...
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It is diagnosed based on an elevated J-point / ST elevation with an end-QRS notch or end-QRS slur and where the ST segment concave up. It is believed to be a normal variant. [2] Benign early repolarization that occurs as some patterns is associated with ventricular fibrillation. The association, revealed by research performed in the late 2000s ...
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The TIMI risk score can identify high risk patients in ST-elevation and non-ST segment elevation MI ACS [30] [31] and has been independently validated. [ 32 ] [ 33 ] Based on a global registry of 102,341 patients, the GRACE risk score estimates in-hospital, 6 months, 1 year, and 3-year mortality risk after a heart attack. [ 34 ]