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