Stemi criteria
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Transcript of Stemi criteria
STEMI on ECG• New ST elevation at J-point in 2 contiguous leads with cut-
points:
• ≥ 0.2 mV in men ≥ 40 years in leads V2 - V3
• ≥ 0.25 mV in men < 40 years in leads V2 - V3
• ≥ 0.15 in women in leads V2 - V3
• ≥ 0.1 mV in all other leads
• In the absence of LVH and LBBB
examples of ST-elevation in MI
Criteria
Paul Sia
for diagnosing
STEMIon ECG
3rd Universal Definition of MI (2012)
STEMI on ECG• New ST elevation at J-point in 2 contiguous leads with cut-
points:
• ≥ 0.2 mV in men ≥ 40 years in leads V2 - V3
• ≥ 0.25 mV in men < 40 years in leads V2 - V3
• ≥ 0.15 in women in leads V2 - V3
• ≥ 0.1 mV in all other leads
• In the absence of LVH and LBBB
examples of ST-elevation in MI
General pitfalls• Beware of baseline ECG abnormalities that may obscure
interpretation
• LBBB
• refer to Sgarbossa’s criteria
• LVH
• J-point elevation syndromes eg, Brugada
• PE
• Peri/myocarditis
• Cardiomyopathy, including Takotsubo
• Cocaine use
• Cardiac pacing
STEMI location• septal
• V1, V2
• inferior
• II, III, aVF
• reciprocal changes: I, aVL
• lateral
• I, aVL, V5, V6
• reciprocal changes: II, III, aVF
• anterior
• V3, V4
• anteroseptal
• V1, V2, V3, V4
• anterolateral
• I, aVL, V3, V4, V5, V6
• reciprocal changes: II, III, aVF
• posterior
• V7, V8, V9
• reciprocal changes: V1, V2, V3, V4
Anterolateral STEMI
ECG 1
Inferior STEMI
ECG 2
ECG 3
Inferolateral STEMI+ Horizontal ST depression V1-3
+ Tall R waves, upright T-waves V2-3
ECG 3 + posterior leads
Inferior-lateral-posterior STEMI
References• Bax, Jeroen J., et al. "Third Universal
Definition of Myocardial Infarction." Journal of the American College of Cardiology 60.16 (2012): 1581-1598.