STEMI guideline

Question 1

name the anterior leads and vessel

Answer 1

V3-V4, left anterior descending

Question 2

name the septal leads and vessel

Answer 2

V1, V2, RCA

Question 3

name the lateral leads and vessel

Answer 3

AVL, I, V5, V6, Cx

Question 4

name the inferior leads and vessels

Answer 4

II, III, AVF, RCA

Question 5

what occurs when there is increased strain on the heart and there is atherosclerosis present

Answer 5

more and more blood is rushed past the area of plaque, which can cause it to rupture

Question 6

what happens when an area of plaque ruptures

Answer 6

1. thrombus forms inhibiting blood flow = ischemic cells

Question 7

what happens to cardiac myocytes starved of 02

Answer 7

decreased rate of contraction until they stop beating, then the die leading to the release of troponins

Question 8

main differentials of STEMI

Answer 8

angina, pericarditis, LBBB. CHF, ACPO

Question 9

guidline diagnosis criteria for a stemi

Answer 9

More than or equal to 2 mm (200 μV) of ST elevation in two or more leads V1-3, or

More than or equal to 1 mm (100 μV) of ST elevation in two or more contiguous leads in any other area.

Question 10

what other information can support the diagnosis of a STEMI

Answer 10

While ST segment elevation is required for STEMI diagnosis, other concurrent ECG changes can support the diagnosis, including T wave changes, evolving ST elevation and reciprocal changes.

Question 11

post ROSC ST elevation

Answer 11

Cardiac arrest may cause transient ST elevation to be present for 20-30 minutes after return of spontaneous circulation, particularly when adrenaline has been administered. Unless the STEMI was diagnosed prior to the cardiac arrest, ST elevation post cardiac arrest should not be immediately treated as STEMI. Consider delaying or repeating the 12 lead ECG ten minutes following ROSC, obtain serial ECGs 15 minutes apart, and have a low threshold for seeking clinical advice.