Deep Dive MW R11

The 6 STEMI Equivalents: * Posterior MI * ST Depression V2/V3 (or STE in V7-V9) * Right Ventricular MI * STE V1 associated with inferior MI ; or STE V4R-V6R * Wellens Syndrome * Type A: Biphasic T-waves V2/3 * Type B: Deep Symmetric T-wave Inversion V2/V3 * De Winter’s T Wave * ST Depression with a large, symmetric, upright T wave * STE avR with diffuse ST-Depression * Usually a strain pattern due to underlying pathology, in correct clinical context can represent a left main or proximal LAD coronary occlusion * Modified Sgarbossa Criteria in LBBB * Concordant STE in any lead * Concordant ST Depression in V1-V3 * Excessive Discordance (ST/S ratio >0.25) Other atypical ischemic EKG findings: * Isolated TWI in avL – early sign of inferior MI * Hyperacute TWave * NTTV1 (New Tall T-wave in V1) Further Reading (see photos in the article): ECG Diagnosis of Life-Threatening STEMI Equivalent’s: Journal of the American College of Cardiology