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Injury, Ischemia, and Infarction patterns

Injury, Ischemia, and Infarction patterns. Basic EKG interpretation. -ST Elevations -ST Depressions -T wave inversions -Non specific ST-T changes -Q waves. ST Elevations. Definition.

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Injury, Ischemia, and Infarction patterns

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  1. Injury, Ischemia, and Infarction patterns Basic EKG interpretation

  2. -ST Elevations -ST Depressions -T wave inversions -Non specific ST-T changes -Q waves

  3. ST Elevations

  4. Definition ●New ST-segment elevation at the J-point in two contiguous leads with the cut-points: ≥0.1 mV (1 mm) in all leads other than leads V2-V3;

  5. Definition ●New ST-segment elevation at the J-point in two contiguous leads with the cut-points: ≥0.1 mV (1 mm) in all leads other than leads V2-V3; ●For leads V2-V3: ≥2 mm in men ≥40 years; ≥2.5 mm in men <40 years, or ≥1.5 mm in women regardless of age.

  6. STEMI imitators -Pericarditis -Prinzmetel’s Angina -Early repolarization -Left Ventricular Hypertrophy -LBBB -Ventricular aneurysm -Ventricular paced -Increased intracranial pressure -Brugada syndrome

  7. ST depression criteria -New horizontal or downsloping ST depression >= 0.5 mm in two contiguous leads -Deeper ST depressions indicate higher likelihood of ACS and worse prognosis

  8. T wave inversions -Inversions deeper than 1 mm in two contiguous leads

  9. Nonspecific ST-T changes -ST-T changes that don’t meet above criteria

  10. Differential diagnosis for Nonspecific ST-T changes -Physiologic variant -Electrolyte abnormalities -Fever -Acidosis/Alkalosis -Endogenous catecholamines -Drugs -Acute abdominal process -Metabolic changes -CVA -Myocarditis -Pericarditis -Pulmonary emboli -Myocardial ischemia -Pulmonary processes

  11. Pathologic Q waves • 40 ms (1mm) in duration • At least 1 mm deep • Greater than 25% of entire QRS amplitude • Two contiguous leads

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