12 Lead
ECG Interpretation
Cheat Sheet Mnemonic?

Does this sound familiar?  It’s 2 a.m. on a Saturday.  You are the lead medical provider in a 15-bed ER.  The computer reading on the ECG states: “Nonspecific ST Changes”, “Diffuse T-wave changes”, “Benign Normal Variant, Cannot Rule Out STEMI”  What!?!? 

We know the computer interpretation on the ECG is notoriously flawed to say the least.  In the setting of an acute STEMI (ST-elevation myocardial infarction), time is cardiac muscle.  You must recognize even subtle changes on the ECG quickly.  

In 2020, *Cardiovascular Disease (CVD) remained the leading cause of death accounting for nearly 1 Million fatalities in the USA.  Such morbidity and mortality costs around $400 Billion dollars in medical costs and lost wages (*AHA Journal). 

• ^Nearly 1.2 million Acute MIs / Year
• Occurrence: approximately 1 Acute MI every 26 minutes in the US
• First symptom of CVD may be Acute MI (STEMI) or Sudden Cardiac Death (SCD)

^ref here for more information 

**STEMI (ST Elevation MI) vs NSTEMI (Non-STEMI) ECG

These terms (STEMI vs NSTEMI) generally represent 2 types of heart attacks as follows:

• #1: In the case of a STEMI on the ECG, there is a complete blockage of the coronary artery.  
• #2 Regarding NSTEMI on the ECG, there is a partial blockage of the artery.   (**additional references)