ST segment depression: Difference between revisions

Latest revision as of 11:05, 25 November 2021

Contour: Most→Least concerning for ischemia: Planar/Flat (90%) → Concave up (33%) → Downsloping with Asymmetric inverted T-wave (not ischemic/strain pattern)
Assume posterior STEMI or reciprocal changes to STEMI until proven otherwise
Indicators of ischemia:
- >0.5mm depression from baseline (especially >1mm) in two or more contiguous leads
- Transient depression
- Morphology that is flat or downsloping
Strain:
- tall R wave
- only in lateral leads (not anterior)
- "checkbox" or asymmetric TWI
- down sloping pattern

ST Elevation Lecture, Dr. Niemann, Harbor-UCLA

Authors:

@@ Line 1: / Line 1: @@
-==DDX==
+==Evaluation==
-#Posterior MI
+*Contour: Most→Least concerning for ischemia: Planar/Flat (90%) → Concave up (33%) → Downsloping with Asymmetric inverted T-wave (not ischemic/strain pattern)
-#RV strain
+*Assume posterior STEMI or reciprocal changes to STEMI until proven otherwise
-#[[NSTEMI]]
+*Indicators of ischemia:
-#Reciprocal changes
+**>0.5mm depression from baseline (especially >1mm) in two or more contiguous leads
-#Electrolyte disorder (e.g. [[hypokalemia]])
+**Transient depression
-#LVH with strain pattern (repolarization abnormality)
+**Morphology that is flat or downsloping
-#Digoxin effect (not indicative of toxicity)
+*Strain:&nbsp;<br>
+**tall R wave
+**only in lateral leads (not anterior)
+**"checkbox" or asymmetric TWI
+**down sloping pattern
+==Differential Diagnosis==
+*[[Posterior MI]] (including posterior [[STEMI]])
+*RV strain
+*[[NSTEMI]]
+*Reciprocal changes
+*[[Electrolyte Disorders]] (e.g. [[hypokalemia]])
+*[[SVT]]
+*[[RBBB]]/[[LBBB]]
+*[[LVH]] with strain pattern (repolarization abnormality)
+*[[Digoxin]] effect (not indicative of toxicity)
+*[[Ventricular paced]] pattern
 ==See Also==
 *[[ECG (Main)]]
-==Source==
+==References==
+<references/>
 ST Elevation Lecture, Dr. Niemann, Harbor-UCLA
-[[Category:Cards]]
+[[Category:Cardiology]]