STEMI MIMICS

Question 1

what is pericarditis

Answer 1

inflammation of the pericardial sac, the sack that is surrounding the heart, causing friction during each heartbeat

Question 2

causes of pericarditis

Answer 2

inflammation of the pericardium can be caused by a virus, idiopathic (no clear cause), post MI, autoimmune disease or due to a caner and or radiation therapy

Question 3

name the process of how pericarditis develops

Answer 3

pericardial layers are infiltrated by immune cells causing inflammation and layers rub causing pain

capillaries become leaky due to inflammatory response, fluid/pus can build up in the sack causing pericardial effusion

pressure from the fluid can progress to cardiac tamponade

Question 4

presentation of pericarditis

Answer 4

sharp chest pain, worse on movement or taking deep breaths, improves when sitting, scratchy rub on auscultation, widespread ST elevation or depression

Question 5

presentation of benign early repol

Answer 5

widespread ST elevation ion young healthy patients

Question 6

LV aneurysm occurs when…

Answer 6

a section of the heart stretches and becomes very thin , can cause ishcemia and thus ST changes

Question 7

causes of LV aneurysm

Answer 7

AMI, infection, cardiomyopathy

Question 8

what is cardiomyopathy

Answer 8

disease of heart muscle, this condition makes it hard for the heart to deliver blood to the body, and can lead to heart failure.

Question 9

factors that favour a left ventricular aneurysm diagnosis rather than STEMI

Answer 9

• same as previous ECGs
• no dynamic changes
• well formed Q waves
• absence of reciprocal changes

Question 10

how to identify LVH vs a STEMI

Answer 10

look at sokolov criteria, old ECGs and look for dynamic changes

Question 11

briefly outline the patho of LVH

Answer 11

is a response to pressure overload in the heart due to HTN and other conditions:

Question 12

ECG changes in LVH

Answer 12

increased R wave amplitude in L side of ECG (I, AVL, V5-6) and increased S wave depth in R sided leads ((III, AVR, V1-3)

Question 13

difference between cardiomyopathy and heart failure

Answer 13

problem with the heart muscle itself vs heart failure which is due to an error of pumping and filling

Question 14

how will cardiomyopathy appear on an ECG

Answer 14

similar to a LBBB

Question 15

how to identify a paced ventricular rhythm

Answer 15

pacing spikes and ST elevation post spikes

Question 16

what is acute myocarditis

Answer 16

inflammation of the middle layer of the heart usually caused by viral infection, ECG changes usually non-specific

Question 17

ECG changes in digoxin toxcityiyt

Answer 17

downslope ST depression

Question 18

name sone of the ECGs changes found in hypothermia

Answer 18

Bradyarrhythmias (see below)
Osborne Waves (= J waves)
Prolonged PR, QRS and QT intervals
Shivering artefact
Ventricular ectopics
Cardiac arrest due to VT, VF or asystole

Question 19

hyperkalemia presentation

Answer 19

peaked T waves

Question 20

hypokalaemia presentation

Answer 20

U wave present