p3medic Posted September 18, 2009 Posted September 18, 2009 Anyone want to discuss STEMI mimics? What else could it be?
okmedic Posted September 19, 2009 Posted September 19, 2009 I'm seeing elevation in v1-v2, depression in v4-v6, inverted T waves throughout, left ventricular hypertrophy(probably from the htn going untreated, possibly a smoker). I would call this a stemi from the diagnostics available because of the elevation greater than one mm, reciprical changes, and the signs of ischemia(even though the symptoms are atypical). As for STEMI mimics....Pericarditis? Am I way off base with my findings or am I in the ballpark? I just started working with a service that actually has and utilizes 12 leads lol.
chbare Posted September 19, 2009 Author Posted September 19, 2009 I think you could argue STEMI; however, the XII lead does not demonstrate the "typical" types of findings seen with STEMI, if we are considering going down a full fibrinolytic path. Pericarditis is a good consideration; however, we typically see global elevation from the inflamed pericardium. Look at all of the findings: + We have flat and depressed ST segments in contiguous leads + We have rather atypical signs and symptoms Lets say that this is in fact an acute coronary syndrome. How many types of ACS exist? Generally speaking, we have three types. 1) STEMI 2) Non STEMI 3) Unstable Angina (USA) For the sake of continuing with the scenario, lets say this is not a STEMI. What do you guys think? Take care, chbare.
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