NSTEMI

Question 1

Signs of NSTEMI on ECG

Answer 1

-ST segment depression- subendocardial ischaemia but no infarction
-T wave inversion- can be normal if had previous MI, if symmetrical its abnormal, (normally +ve in 1,2, V3-V6 and -ve in aVR)
-pathological (too big) Q waves - (higher mortality rate)

Question 2

Wellen’s syndrome

Answer 2

-characterised by biphasic or deeply inverted T waves in V2-3 plus history of recent chest pain
-specific for critical stenosis of left anterior descending artery

Question 3

Unstable angina v NSTEMI

Answer 3

-UA and NSTEMI can have T wave changes or ST depression
-however no pathological Q waves in UA only NSTEMI as no infarction in UA
-if no pathological Q, can only differentiate UA or NSTEMI by cardiac biomarkers of coronary angiogram

Question 4

Pathological Q waves

Answer 4

-can be normal for people who have had a STEMI
Considered pathological if:
- greater than 40ms/ 1mm wide
- greater than 2mm deep
- greater than 25% depth of QRS
- leads V1-V3 regardless of size/ width