OMI

Question 1

Answer 1

Hyperacute T-waves - Inferior 1

Broad, asymmetrically peaked or ‘hyperacute’ T-waves seen in early stages of MI.
Disproportionately increased area under the ST segment and T wave compared to the QRS
“Inflating the T-wave like a balloon”

De Winter pattern = tall, prominent, symmetric, anterior precordial T waves with upsloping ST segment depression

Question 2

Answer 2

Hyperacute T-waves - Inferior 2

Broad, asymmetrically peaked or ‘hyperacute’ T-waves seen in early stages of MI.
Disproportionately increased area under the ST segment and T wave compared to the QRS
“Inflating the T-wave like a balloon”

De Winter pattern = tall, prominent, symmetric, anterior precordial T waves with upsloping ST segment depression

Question 3

Answer 3

Hyperacute T-waves - Inferior 3

Broad, asymmetrically peaked or ‘hyperacute’ T-waves seen in early stages of MI.
Disproportionately increased area under the ST segment and T wave compared to the QRS

“Inflating the T-wave like a balloon”

De Winter pattern = tall, prominent, symmetric, anterior precordial T waves with upsloping ST segment depression

Question 4

Answer 4

Hyperacute T-waves - Inferior 4

Broad, asymmetrically peaked or ‘hyperacute’ T-waves seen in early stages of MI.

Disproportionately increased area under the ST segment and T wave compared to the QRS

“Inflating the T-wave like a balloon”

De Winter pattern = tall, prominent, symmetric, anterior precordial T waves with upsloping ST segment depression

Question 5

Answer 5

Hyperacute T-waves - Anterior 1

Broad, asymmetrically peaked or ‘hyperacute’ T-waves seen in early stages of MI.
Disproportionately increased area under the ST segment and T wave compared to the QRS
“Inflating the T-wave like a balloon”
De Winter pattern = tall, prominent, symmetric, anterior precordial T waves with upsloping ST segment depression

Question 6

Answer 6

Hyperacute T-waves - Anterior 2

Broad, asymmetrically peaked or ‘hyperacute’ T-waves seen in early stages of MI.
Disproportionately increased area under the ST segment and T wave compared to the QRS
“Inflating the T-wave like a balloon”
De Winter pattern = tall, prominent, symmetric, anterior precordial T waves with upsloping ST segment depression

Question 7

Answer 7

Hyperacute T-waves - Anterior 3

Broad, asymmetrically peaked or ‘hyperacute’ T-waves seen in early stages of MI.
Disproportionately increased area under the ST segment and T wave compared to the QRS
“Inflating the T-wave like a balloon”
De Winter pattern = tall, prominent, symmetric, anterior precordial T waves with upsloping ST segment depression

Question 8

Answer 8

Hyperacute T-waves - Anterior 4
Broad, asymmetrically peaked or ‘hyperacute’ T-waves seen in early stages of MI.
Disproportionately increased area under the ST segment and T wave compared to the QRS
“Inflating the T-wave like a balloon”
De Winter pattern = tall, prominent, symmetric, anterior precordial T waves with upsloping ST segment depression

Question 9

Answer 9

Hyperacute T-waves - Anterior 5

Broad, asymmetrically peaked or ‘hyperacute’ T-waves seen in early stages of MI.
Disproportionately increased area under the ST segment and T wave compared to the QRS
“Inflating the T-wave like a balloon”
De Winter pattern = tall, prominent, symmetric, anterior precordial T waves with upsloping ST segment depression

Question 10

Answer 10

Posterior MI - 1
ST depression maximal in V1-V4 (rather than V4-V6 as in diffuse demand ischemia)
Horizontal ST depression
Not technically in STEMI criteria, but some consider 0.5 mm in one posterior lead sufficient

Question 11

Answer 11

Posterior MI - 2
ST depression maximal in V1-V4 (rather than V4-V6 as in diffuse demand ischemia)
Horizontal ST depression
Not technically in STEMI criteria, but some consider 0.5 mm in one posterior lead sufficient

Question 12

Answer 12

Posterior MI - 3
ST depression maximal in V1-V4 (rather than V4-V6 as in diffuse demand ischemia)
Horizontal ST depression
Not technically in STEMI criteria, but some consider 0.5 mm in one posterior lead sufficient

Question 13

Answer 13

Posterior MI - 4
ST depression maximal in V1-V4 (rather than V4-V6 as in diffuse demand ischemia)
Horizontal ST depression
Not technically in STEMI criteria, but some consider 0.5 mm in one posterior lead sufficient

Question 14

Answer 14

Posterior MI - 5
ST depression maximal in V1-V4 (rather than V4-V6 as in diffuse demand ischemia)
Horizontal ST depression
Not technically in STEMI criteria, but some consider 0.5 mm in one posterior lead sufficient

Question 15

Answer 15

Posterior MI - 6
ST depression maximal in V1-V4 (rather than V4-V6 as in diffuse demand ischemia)
Horizontal ST depression
Not technically in STEMI criteria, but some consider 0.5 mm in one posterior lead sufficient

Question 16

Answer 16

STE < STEMI criteria
OMI may manifest in any wall of the heart with STE that is simply less than the criteria, or not in two contiguous leads

Question 17

Answer 17

STE < STEMI criteria - 2

OMI may manifest in any wall of the heart with STE that is simply less than the criteria, or not in two contiguous leads

Question 18

Answer 18

STE < STEMI criteria - 3
OMI may manifest in any wall of the heart with STE that is simply less than the criteria, or not in two contiguous leads

Question 19

Answer 19

STE < STEMI criteria - 3
OMI may manifest in any wall of the heart with STE that is simply less than the criteria, or not in two contiguous leads

Question 20

Answer 20

STE < STEMI criteria - 4
OMI may manifest in any wall of the heart with STE that is simply less than the criteria, or not in two contiguous leads

Question 21

Answer 21

STE < STEMI criteria - 5
OMI may manifest in any wall of the heart with STE that is simply less than the criteria, or not in two contiguous leads

Question 22

Answer 22

STE < STEMI criteria - 6
OMI may manifest in any wall of the heart with STE that is simply less than the criteria, or not in two contiguous leads

Question 23

Answer 23

STE < STEMI criteria - 7
OMI may manifest in any wall of the heart with STE that is simply less than the criteria, or not in two contiguous leads

Question 24

Answer 24

LBBB - 0
Modified Sgarbossa Criteria
Concordance at least 1mm
Discordance at least 25% of preceding S-wave

Question 25

Answer 25

LBBB - 1 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 26

Answer 26

LBBB - 2 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 27

Answer 27

LBBB - 3 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 28

Answer 28

LBBB - 4 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 29

Answer 29

LBBB - 5 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 30

Answer 30

Ventricular Paced Rhythm - 0 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 31

Answer 31

Ventricular Paced Rhythm - 1 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 32

Answer 32

Ventricular Paced Rhythm - 2 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 33

Answer 33

Ventricular Paced Rhythm - 3 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 34

Answer 34

Ventricular Paced Rhythm - 5 Modified Sgarbossa Criteria Concordance at least 1mm Discordance at least 25% of preceding S-wave

Question 35

Answer 35

ACS with new RBBB + LAFB - 0 Usually with anterolateral STE High risk sign of proximal LAD OMI

Question 36

Answer 36

ACS with new RBBB + LAFB - 1 Usually with anterolateral STE High risk sign of proximal LAD OMI

Question 37

Answer 37

ACS with new RBBB + LAFB - 2 Usually with anterolateral STE High risk sign of proximal LAD OMI

Question 38

Answer 38

ACS with new RBBB + LAFB - 3 Usually with anterolateral STE High risk sign of proximal LAD OMI

Question 39

Answer 39

ACS with new RBBB + LAFB - 3 Usually with anterolateral STE High risk sign of proximal LAD OMI

Question 40

Answer 40

ACS with new RBBB + LAFB - 5 Usually with anterolateral STE High risk sign of proximal LAD OMI

Question 41

Answer 41

Right Ventricular MI - 0 STE in V1, usually in the setting of inferior OMI Some consider one right-sided lead with > 0.5 mm “diagnostic”

Question 42

Answer 42

Right Ventricular MI - 1 STE in V1, usually in the setting of inferior OMI Some consider one right-sided lead with > 0.5 mm “diagnostic”

Question 43

Answer 43

Right Ventricular MI - 3 STE in V1, usually in the setting of inferior OMI Some consider one right-sided lead with > 0.5 mm “diagnostic”

Question 44

Answer 44

Right Ventricular MI - 4 STE in V1, usually in the setting of inferior OMI Some consider one right-sided lead with > 0.5 mm “diagnostic”

Question 45

Answer 45

Right Ventricular MI - 5 STE in V1, usually in the setting of inferior OMI Some consider one right-sided lead with > 0.5 mm “diagnostic”

Question 46

Answer 46

Left Main ACS - 0 ACS + diffuse STD + aVR STE Does not generally equal LM occlusion (which presents as sudden death or OMI), but can be critical thrombotic stenosis which benefits from intervention

Question 47

Answer 47

Left Main ACS - 1 ACS + diffuse STD + aVR STE Does not generally equal LM occlusion (which presents as sudden death or OMI), but can be critical thrombotic stenosis which benefits from intervention

Question 48

Answer 48

Left Main ACS - 2 ACS + diffuse STD + aVR STE Does not generally equal LM occlusion (which presents as sudden death or OMI), but can be critical thrombotic stenosis which benefits from intervention

Question 49

Answer 49

Left Main ACS - 4 ACS + diffuse STD + aVR STE Does not generally equal LM occlusion (which presents as sudden death or OMI), but can be critical thrombotic stenosis which benefits from intervention

Question 50

Answer 50

Left Main ACS - 3 ACS + diffuse STD + aVR STE Does not generally equal LM occlusion (which presents as sudden death or OMI), but can be critical thrombotic stenosis which benefits from intervention

Question 51

Answer 51

Wellen’s syndrome