Monthly Archives: September 2011

Think posterior infarction

When assessing ST segment depressions in contiguous leads V1-V3 don’t miss a posterior STEMI (commonly associated with inferior MI and can be isolated in 4% of AMI cases). Get additional posterior leads V8 and V9 which increase sensitivity for acute … Continue reading

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Troponins and ESRD

Elevated troponins may be present in asymptomatic patients with ESRD. The TnT isoform is associated with elevated levels in renal failure more than TnI. Elevated troponins in renal failure are associated with increased risk of death and vascular morbidity. The … Continue reading

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ST changes in LBBB and paced rhythms

Sgarbossa criteria (EKG changes concerning for acute AMI) in LBBB and paced rhythms. Specificity of 90% needs score of ≥ 3. ST segment elevation of at least 1mm that is concordant with the ORS complex (5 points) ST segment depression … Continue reading

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Look at aVR

aVR ST elevation accompanied by either anterior ST elevation or widespread ST-segment depression may indicate left main occlusion. The typical electrocardiographic (ECG) finding in cases with preserved flow through the left main is widespread ST-segment depression maximally in leads V4-V6 … Continue reading

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