TRAUMA YELLOW
  • Clinical
    • Discharge Macros
    • Procedure Macros
    • Exam Macros
    • Pediatric Macros
    • Antibiogram
    • Follow Up
    • 2023 MDM
    • Heart Pathway
    • Jeromy's Macros
  • Education
    • EM Education
    • Critical Care
    • FOAM
  • Orientation
    • Dept Orientation
    • Cerner
    • Dragon
  • Links
    • Clinical Links
    • StatMacros
    • ICU Bootcamp
  • Private
    • MCS
    • GWU Contacts & Map

EKG Challenge #4: 61 yo male with chest pain

11/7/2017

0 Comments

 
61 year old presents to the ED with chest pain radiating to his ​​shoulder
Picture
What is the diagnosis?
Anterior STEMI
Elevations of the ST segments in the precordial leads. There are ST depressions (reciprocal changes) inferiorly (Green arrows), poor R wave progression (Red) and T waves that are more symmetric (yellow). Additionally the patient is 61 years old.
Picture
Why Not...
Why is this not Benign Early Repolarization?
The differentiation of benign ST elevations (BER) and Anterior STEMI can be difficult. There are a number of characteristics which are suggestive of BER vs. STEMI. Make sure to examine for other ischemic changes. Our job is to exclude MI and BER should be diagnosis of exclusion. Some features suggestive of each in below table.
Picture
Learn more
Consider using the Subtle Anterior STEMI calculator in cases where you are concerned, but the EKG may be difficult to decipher
0 Comments



Leave a Reply.

    Categories

     

    All
    Abx
    Article
    Cardiac
    EKG
    EKG Challenge
    GI Bleed
    Grand Rounds
    Headache
    ICU
    Orthopedic
    Pain
    Peds
    Reading
    Stroke
    Subarachnoid Hemorrhage
    Syncope
    Teaching Pearl
    Trauma
    Travel
    Zika

    Archive

     

    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    January 2016
    December 2015
    November 2015

    Picture
    Please read our Terms of Use.
Donate
This site is independently owned and operated and not affiliated with the George Washington University, George Washington University Hospital, or Medical Faculty Associates. All information on this site is the opinion of the author alone and in no way should be seen to represent the views of the George Washington University, George Washington University Hospital, or Medical Faculty Associates. The information on this page is for personal use only and should not be see as medical advice or used directly for patient care. The author provides no guarantee of the accuracy of the information provided on this page. ​

​Please refer to our Terms of Use. 
  • Clinical
    • Discharge Macros
    • Procedure Macros
    • Exam Macros
    • Pediatric Macros
    • Antibiogram
    • Follow Up
    • 2023 MDM
    • Heart Pathway
    • Jeromy's Macros
  • Education
    • EM Education
    • Critical Care
    • FOAM
  • Orientation
    • Dept Orientation
    • Cerner
    • Dragon
  • Links
    • Clinical Links
    • StatMacros
    • ICU Bootcamp
  • Private
    • MCS
    • GWU Contacts & Map