EMT Podcast:

Emergency Medicine Tutorials

ST Segment Elevation

You don't need to know these (unless you are about to sit a silly exam) but just be aware that there are other causes of ST elevation before you thrombolyse someone esp LBBB, LV aneurysm, pericarditis, early repolarisation, WPW and STEMI from thoracic aortic dissection
 
13 causes
 
Distant
  • Intracranial haemorrhage
  • Hypothermia
 
Outer surface of heart
  • pericarditis/myocarditis
  • vessels = Prinzmetals
Myocardium
  • MI
  • LVH
  • LV aneurysm
  • Brugada
  • Early repolarisation

Conduction system

  • WPW
  • BBB
  • Paced rhythm
Blood
  • Hyper K
 
ċ
 11 causes of ST segment elevation. EMRAP TV 2008. MOV
View		 QuickTime movie file  5 May 2009 04:54 Chris Cresswell
Ċ AssessingthediagnosticvalueofanECGcontainingleadsV4R,V8,andV9The15-LeadECG.pdf
View Download		 Assessing the diagnostic value of an ECG containing leads V4R, V8, and V9: The 15-Lead ECG. ANNALS 0F EMERGENCY MEDICINE 22:5 MAY 1993 28/786   1344k v. 3 8 Jul 2009 05:36 Chris Cresswell
Ċ ECGinferiorMI.pdf
View Download		 Electrocardiographic manifestations: acute inferior wall myocardial infarction. Rotondo N, Pollack ML, Chan TC, Brady WJ, Harrigan RA.J Emerg Med. 2004 May;26(4):433-40. Advocates R sided and posterior leads in all patients with inferior MI  886k v. 2 7 Jul 2009 09:35 Chris Cresswell
Ċ Electrocardiographicmanifestationsofrightventricularinfarction.pdf
View Download		 Electrocardiographic manifestations of right ventricular infarction. American Heart Journal Volume 118, Issue 1, July 1989, Pages 138-144   1540k v. 2 8 Jul 2009 05:33 Chris Cresswell
Ċ Guidelinesforthemanagementofacutecoronarysyndromes2006.MJAVolume184Number82006.pdf
View Download		   1074k v. 1 20 Aug 2009 07:10 Chris Cresswell
Ċ Myocardialinfarctionredefined2000.pdf
View Download		 Myocardial infarction redefined — A consensus documentof The Joint European Society of Cardiology/AmericanCollege of Cardiology Committee for the Redefinition ofMyocardial Infarction. European Heart Journal (2000) 21, 1502–1513  159k v. 3 8 Jul 2009 05:31 Chris Cresswell