ECG in acute STEMI (ST Elevation Myocardial Infarction) The ECG is the key to diagnosing STEMI. ECG criteria for STEMI are not used in the presence of left bundle branch block or left ventricular hypertrophy (LVH) because these conditions cause secondary ST-T changes which may mask or simulate ischemic ST-T changes.

2025年1月18日 · Management Recommendation Level of evidence; The pre-hospital care of STEMI patients should be organized regionally (including all components from the emergency medical dispatch to catheterization laboratory) in order to …

In STEMI/STE-ACS, on the other hand, reciprocal ST segment depressions are typical and there may be T-wave inversions in the same leads showing ST segment elevation. T-wave inversion may, however, occur in perimyocarditis, but only after normalization of the ST segment elevations (i.e these two ECG changes do not occur simultaneously).

In patients with STEMI, ST-segment elevations and pathological Q-waves occur in the same leads, which is why pathological Q-waves can be used to localize the infarct area. Figure 1. Definition of pathological Q-waves. ECG criteria for pathological Q-waves (Q-wave infarction)

ECG changes and extension of the infarction depend heavily on the site of the occlusion. The more proximal the occlusion the greater the infarction and the more pronounced ECG changes. ST-segment elevations may be present in leads V1–V6, and frequently aVL, I (the latter two may be affected because the diagonals given off by the LAD supply ...

Figure 1. (A) The relation between the action potential and the ECG curve. Myocardial ischemia primarily affects repolarization, which is reflected in ST-T changes on the ECG. (B) Note that the reference level for measuring deviation (elevation or depression) of the ST segment is the PR segment (the terminal portion of the PR interval).

To conclude, patients with chest discomfort who display ST segment depressions in leads V1–V3 are likely have posterolateral transmural ischemia and should be managed as STE-ACS/STEMI (ST elevation myocardial infarction). ECG criteria for posterolateral (posterior, inferobasal) ST segment elevation myocardial infarction (STE-ACS/STEMI):

2025年1月25日 · Reperfusion therapy (primary PCI, fibrinolysis) in patients with acute coronary syndromes (STEMI, NSTEMI, unstable angina) Antiplatelet therapy and anticoagulants in STEMI, NSTEMI and unstable angina Antithrombotic regimens in patients with ACS with and without an indication for oral anticoagulation

ECG criteria for posterolateral (posterior, inferobasal) ST segment elevation myocardial infarction (STE-ACS/STEMI): ST-segment elevation in V7-V9: ≥0,5 mm in at least one lead (males and females). Differentiating posterolateral ischemia from right ventricular hypertrophy (RVH)

Short-term mortality is higher in STEMI than non-STEMI, but long-term mortality is higher in the non-STEMI group which is usually explained by the fact that patients with Non-STEMI are older and have more comorbidities. As seen in Figure 3, roughly 7% of patients with STEMI die within 30 days, as compared with 3–5 % of patients with non-STEMI.