Pre PACES Podcast #113 BAMR Calling Cardiology (STEMIs)
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May 11, 2025 Join Dr. Bunny Saberwal, a consultant cardiologist specializing in acute coronary syndromes, and Dr. Retesh Bajaj, a senior registrar skilled in interventional cardiology, as they delve into the intricate world of STEMI management. They discuss the critical importance of context in ECG interpretation and share key features that confirm STEMI. Learn when to prioritize thrombolysis, the significance of serial ECGs, and the nuances of managing aortic dissection. A treasure trove of insights for anyone in cardiology!
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Always Pair ECG With Clinical Picture
- Never interpret an ECG in isolation; always correlate with the patient's clinical state.
- If the patient is unwell and you suspect STEMI, send them promptly rather than over-rely on ECG ambiguity.
Reciprocal Changes And Dynamics Matter
- Reciprocal changes and dynamic evolution on serial ECGs strongly indicate acute ischaemia.
- Chronic ST elevation and benign early repolarization can mimic STEMI, so compare with old ECGs when possible.
Repeat ECGs And Treat New LBBB Carefully
- Always obtain repeat ECGs to demonstrate dynamic ST changes; one snapshot can mislead.
- Treat 'new left bundle' claims cautiously and prioritise the overall clinical severity.