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The clinician must therefore be well versed in recognizing the so-called ECG mimics of acute myocardial infarction, which include left ventricular hypertrophy, left bundle branch block, paced rhythm, early repolarization, pericarditis, hyperkalemia, and ventricular aneurysm. [7] [8] [9] Localisation of the occlusion in the ECG showing STEMI changes
Several other studies have evaluated the usefulness of different ECG findings in diagnosing MI when LBBB is present. Smith et al. modified Sgarbossa's original criteria. [6] Smith modified Sgarbossa rule: at least one lead with concordant STE (Sgarbossa criterion 1) or; at least one lead of V1-V3 with concordant ST depression (Sgarbossa ...
People who have a normal ECG and who are able to exercise, for example, do not merit routine imaging. [13] Imaging tests such as stress radionuclide myocardial perfusion imaging or stress echocardiography can confirm a diagnosis when a person's history, physical exam, ECG and cardiac biomarkers suggest the likelihood of a problem. [13]
Acute coronary syndrome is subdivided in three scenarios depending primarily on the presence of electrocardiogram (ECG) changes and blood test results (a change in cardiac biomarkers such as troponin levels): [4] ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina. [5]
Schematic representation of normal ECG In electrocardiography , the ST segment connects the QRS complex and the T wave and has a duration of 0.005 to 0.150 sec (5 to 150 ms). It starts at the J point (junction between the QRS complex and ST segment) and ends at the beginning of the T wave.
A 12-lead ECG showing an inferior STEMI due to reduced perfusion through the right coronary artery. Elevation of the ST segment can be seen in leads II, III and aVF. Electrocardiograms (ECGs) are a series of leads placed on a person's chest that measure electrical activity associated with contraction of the heart muscle. [87]
If an MI is presented with ECG evidence of an ST elevation known as STEMI, or if a bundle branch block is similarly presented, then reperfusion therapy is necessary. In the absence of an ST elevation, a non-ST elevation MI, known as an NSTEMI , or an unstable angina may be presumed (both of these are indistinguishable on initial evaluation of ...
Moreover, in the post-resuscitation patient, a 12-lead EKG can help identify some causes of cardiac arrest, such as STEMI which may require specific treatments. Point-of-care ultrasound (POCUS) is a tool that can be used to examine the movement of the heart and its force of contraction at the patient's bedside. [66]