Can you call a STEMI on a paced rhythm?

Right now, there are not very good data or scores to diagnose a STEMI from a paced ECG. At this time, it appears that the third of the original Sgarbossa criteria is the most specific for an acute MI with specificity ranging from 88% – 99%, but with a low sensitivity (10%-32%).

How do you diagnose MI in paced rhythm?

MI Diagnosis in LBBB or paced rhythm

1. ST elevation > 1mm in leads with a positive QRS complex (concordance in ST deviation) (score 5)
2. ST depression > 1 mm in V1-V3 (concordance in ST deviation) (score 3)
3. ST elevation > 5 mm in leads with a negative QRS complex (inappropriate discordance in ST deviation) (score 2).

What are STEMI criteria?

Classically, STEMI is diagnosed if there is >1-2mm of ST elevation in two contiguous leads on the ECG or new LBBB with a clinical picture consistent with ischemic chest pain. Classically the ST elevations are described as “tombstone” and concave or “upwards” in appearance.

Can Sgarbossa criteria be applied to a paced rhythm?

The Sgarbossa and Smith-modified Sgarbossa criteria have been documented to enhance the diagnosis of STEMI in the setting of LBBBs. However, there is a growing body of literature that suggests that these criteria can also be applied for the diagnosis of STEMI in patients with paced rhythms.

What does an elevated ST segment on an EKG mean?

St Elevation (Definition) St elevations refers to a finding on an electrocardiogram, wherein the trace in the st segment is abnormally high above the isoelectric line. Ekg st segment elevation is usually attributed to impending infarction, but can also be due to pericarditis or vasospastic (variant) angina and early repolarization.

What is STEMI medical term?

STEMI is a shorthand medical term for ST-segment elevation myocardial infarction. It is one type of heart attack that can be defined as a development of full thickness cardiac muscle damage resulting from an acute interruption of blood supply to a part of the heart and can be demonstrated by ECG (electrocardiography) change of ST-segment elevation.

What causes change in EKG?

Enlargement of the heart or specific chambers of the heart also cause EKG changes. A wide variety of conditions, ranging from certain infections to lupus, can inflame the heart muscle or its lining leading to characteristic EKG abnormalities.

What is a 5 lead EKG?

5 lead ECG monitoring. Occasionally a 5 lead ECG is also used for monitoring purposes. It uses 4 electrodes like a 3 lead ECG with an additional 5th electrode placed on the chest. Usually these devices do not produce a print out of the electrocardiogram and may not store the information for further review.