STEMI Criteria Flashcards
What are the ST elevation criteria for STEMI?
- ST elevation 1mm or more in 2 or more adjacent leads except V2 and V3, which require:
- > 1.5mm in women
- > 2mm in men >40 years
- > 2.5mm in men <40 years
- LBBB and haemodynamically unstable
- LBBB with positive modified Sgarbossa criteria
- Posterior infarct
- De Winters T waves.
What are STEMI mimics?
Wellens and Brugada syndromes.
These conditions are high risk and require cardiology referral but are not indications for thrombolysis.
Fill in the blank: ST elevation of >1.5mm in women is a criterion for _____ in leads V2 and V3.
STEMI
This is part of the specific criteria for diagnosing STEMI in women.
What is required for LBBB to be considered a criterion for STEMI?
- LBBB and haemodynamically unstable
- LBBB with positive modified Sgarbossa criteria
These conditions indicate that LBBB may signify an underlying STEMI.
What does De Winters T waves indicate?
STEMI
2% of LAD STEMIs present with de-Winters
Upsloping ST segment depression > 1mm at the J point in the precordial leads
Reciprocal ST segment elevation (0.5mm – 1mm) in aVR
What is the first criterion of the Smith-Modified Sgarbossa Criteria?
Concordant ST elevation ≥ 1 mm in ≥ 1 lead
Used for pre-existing LBBB or paced rhythms
What is the second criterion of the Smith-Modified Sgarbossa Criteria?
Concordant ST depression ≥ 1 mm in ≥ 1 lead of V1-V3
This criterion focuses on ST depression in specific precordial leads.
What is the third criterion of the Smith-Modified Sgarbossa Criteria?
Proportionally excessive discordant STE in ≥ 1 lead anywhere with ≥ 1 mm STE, as defined by ≥ 25% of the depth of the preceding S-wave
This criterion assesses discordant ST elevation relative to the preceding S-wave.
What is the specificity of the Modified Sgarbossa criteria in diagnosing myocardial infarction with a total score of ≥ 3?
90%
Modified Sgarbossa criteria: What is the sensitivity for myocardial infarction?
36%
