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REBEL Core Cast 104.0 – Subtle ECGs in Acute Coronary Occlusion

By Marco Torres July 05, 2023 0 comments

Take Home Points

  1. Provider assessment of how the patient looks is extremely important. If it looks and feels like a STEMI clinically, get serial ECGs and consult Cardiology immediately.

  2. POCUS has been a phenomenal tool in the management and early diagnosis of a lot of abnormal ECG and chest pain presentations.

  3. Isolated elevation in aVR with diffuse ST depressions can be a sign of Left Main occlusion. History is important as this can also be seen in other sick patient populations (e.g. Sepsis)

  4. De Winters T waves are the earliest sign of an anterior wall MI but will only be present in ~ 2% of LAD infarcts

  5. Patients with Wellens Syndrome on ECG should have a cardiac cath within 24 hours, not necessarily within the first 60 minutes of ED arrival.

REBEL Core Cast 104.0 – Subtle ECGs in Acute Coronary Occlusion

Modified Sgarbossa Criteria
deWinters ECG
Wellens’ Syndrome
STEMI Criteria (Taming of the SRU)

Resources

The post REBEL Core Cast 104.0 – Subtle ECGs in Acute Coronary Occlusion appeared first on REBEL EM - Emergency Medicine Blog.


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