Emergency Medical Minute Podcast 628: ST Elevation
Contributor: Peter Bakes, MD
Educational Pearls:
- STEMI criteria is not just 1mm elevation in contiguous leads
-
- 1.5 mm in V2-V3 for women
- 2.0 mm in V2-V3 for men
- 2.5 mm in V2-V3 for men under 40
- Inferior MI typically have ST elevation in leads II, III and aVF
-
- Usually inferior MI's show reciprocal changes (ST depression) in the lateral leads.
- Lateral MI typically elevation in V5, V6, I, and aVL
- Anterior MI show elevation in leads V1-4
- Right sided MIs have mixed pattern, showing elevation in V1-V2 and V4 along with the inferior leads.
- Right sided MI's are very sensitive to nitrates, especially if they become intubated because this combination can drop pre-load significantly leading to profound hypotension
References
Akbar H, Foth C, Kahloon RA, et al. Acute ST Elevation Myocardial Infarction. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532281/
Namana V, Gupta SS, Abbasi AA, Raheja H, Shani J, Hollander G. Right ventricular infarction. Cardiovasc Revasc Med. 2018 Jan;19(1 Pt A):43-50. doi: 10.1016/j.carrev.2017.07.009. Epub 2017 Jul 14. PMID: 28822687.
Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD
The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.