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Flashcards in STEMI NSTEMI Deck (28):
1

LCA is visualized as positive ___ leads

I and aVL V5 and V6

these are both LATERAL

I is alone and can look like an L
L is lateral

5 and 6 Lateral

2

which leads are positive in STEMI occlusions of the RCA

II
III
AVF

also known as the
inferior leads
RCA down

3

which leads are seen with positive in the septal portion of LAD

V1 and V2

septal leads

l

4

anterior leads are ____ which correlate with which artery

V3 AND V4

5

elevation in V1-V4

anteroseptal infarct affecting the LAD

6

cardiac enzymes

troponin is good sensitivity and specificity


although other conditions like renal failure and CHF can cause them

high sensitivity for CRP
and CK-MB creatine kinase MB iso enzyme

more useful in certain situations

7

STEMI mngmt

get to the effin cath lab
door to balloon <90 minutes

cardiac monitor
supplement O2
nitrates
beta blocjer
morphine
aspirin
good IV access

8

risk stratifications

TIMI score

>65
> 3 CAD risk factors
document CAD
documented CAD w/ >50%
ST segment deviation
>2 anginal episodes in the past 24 hours
ASA use in the past week
elevation of enzymes

stratefy
0-2 low

3-4 intermediate

5-7 high risk
****

9

myocardial infarction mimics

benign early repo
pericarditis
brugada

10

what do we see as characterisitc of benign early repo

widespread ST
notched J point fish hook
tall-T waves in precordial leads
concave ST elevation
no reciprocal changes

11

where would we see the early benign repo

V2-V5

look for the happy face

12

how to tell pericarditis from STEMI

would have ST elevations in all leads except for aVR
and V1

in pericarditis

13

causes of pericarditis

viral infection
trauma
drug induced
post MI (Dresseler's )

14

signs of pericarditis

pericardial friction rub
possible effusion

15

brugada what is it

inherited channelopathy


with ST elevation and partial RBBB in V1 and V2

16

what is a U wave seen in electrolyte disturbances

repolorization of the purkinje fibers

can be seen fused with a T

17

hypokalemia can transition into

ventricular arrhythmia

18

how low does K for hypokalemia

<3.5 mmol/L

seen on EKG with <2.7

19

why is hyperkal dangerous

what do we see

can still cause cardiac toxicity

peaking of T waves
PR interval prolongation
diminished or absent P
widening of QQRS in sine wave pattern

20

when do we see hyperkalemia on EKG

above 6.5

greater than 9 =ventricular arrhythmias

21

when do we being to see a sine wave

hyper kalemia over 9

22

how do we differentiate BBB from hyperkalemia

bunny ears in V1 and slurred S in V6

vs

hyperkalemia

peaked T everywhere

23

how to reverese hyperkalemia

memebrane stabilizations:
calcium gluconateand hypertonic normal saline

shifters: insulin and albuterol

excreters: sodium bicarboante
furosemide
sodium polystyrene

24

signs of dig toxicity

anorexia
N/V
visual changes-yellow halo
palpitations
decrease HR

25

what do we see with dig toxicity

ST segment and T wave fused

26

what are the SE of dig

HA weakness seizure drowsiness

27

stable angina

exertional
<20 minutes
same pattern
releived with rest and medication

28

unstable angina

occurs at rest
>20 minutes
different pattern
doesn't respond to rest
new onset that limits activity