TRACING 16
Tracing 16: STEMI?
We observe the following from the above tracing:
- ST elevation(concave down) Leads II, III, avF
- ST depressions of reciprocity Leads I, avL
- Of note is the absence of LVH and LBBB
Summary: This tracing meets the criteria of Acute ST Elevation Inferior MI.
PEARL : In the setting of Inferior STEMI, I recommend the routine placement of posterior leads(V7V8V9) and right precordial leads (V4R). This might uncover an injury pattern in these areas and at the very least demonstrates that you considered the posterior and RV infarction.
Yes. This is an Acute STEMI.
Tracing 17
Tracing 17: STEMI?
We note in the above tracing:
- Diffuse ST elevation concave up (catenary shaped)
- Essentially all lying on baseline— PR-segments, ST-segments
Summary: ST Elevation of Benign Normal Variant (Early Repolarization)
No. This tracing is not an acute STEMI.
Tracing 18
Tracing 18: STEMI?
We observe the following from the above tracing:
- Significant Q-wave V1, V2, V3
- ST elevation and peaked T-waves V2 → V6, I, avL
- ST depression II, III, avF
- Of note is the absence of LVH and LBBB
Summary: This tracing meets the criteria for the Acute Anteroseptal STEMI.
Yes. This tracing is an acute STEMI.
Tracing 19
Tracing 19: STEMI?
We observe the following from the above tracing:
- |QRS| normal
- R + S > 35 mm
- Peaked Ts and ST elevation V1 → V4
- ST depression, ramp-like V5, V6, II
- Atrial fibrillation Rhythm
Summary: LVH with ST-T changes (strain pattern) – pseudoinfarction pattern. Atrial Fibrillation.
No. This tracing is not a STEMI.
Tracing 20
Tracing 20: STEMI?
In the above tracing we observe:
- Significant Q-waves V1, V2
- ST elevations V1, V2, V3
- ST depressions V4, V5, V6, I, II, avF
- (tallest)R + (tallest)S > 35 mm in precordial leads
Summary: LVH with ST-T changes. Pseudoinfarction pattern.
No. This tracing is not an acute STEMI.
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