STEMI Equivalents on ECG
 • Conventional STEMI - Elevation ...
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Description

STEMI Equivalents on ECG
 • Conventional STEMI - Elevation of ST segment at (or 40-60 ms after) the J point
 • De Winter syndrome - J-point depression and upsloping ST depression in V1-V6 that continues into tall, positive symmetrical T-waves, often with 1-2 mm ST elevation in aVR
 • Posterior STEMI - ST depression ≥ 0.05 mV (horizontal or downsloping and concave) in V1-V3 (or V4) especially if there is a tall R in V1/V2 with R/S ratio > 1 in V2
 • Wellens sign A - Biphasic anterior T waves, not always accompanied by chest pain
 • Wellens sign B - Deeply inverted anterior T waves, not always accompanied by chest pain
 • Hyperacute T wave - Tall, often asymmetrical, broad-based anterior T-waves often associated with reciprocal ST depression
 • Sgarbossa criterion 1 - ST elevation ≥ 0.1 mV concordant to the QRS in any of the leads l, aVL, V4 to V6
 • Sgarbossa criterion 2 - ST depression ≥ 0.1 mV concordant to the QRS in any of the leads V1 to V3.
 • Sgarbossa criterion 3 (modified) - ST elevation with amplitude >25% of the depth of the preceding S-wave with discordant QRS complex (leads V1 to V3)
 • "Shark fin" - J-point transitioning in a convex ST-segment (T wave indistinguishable from ST-segment due to extreme ST deviation)
 • Acute ischemia in LVH - ST elevation >25% of QRS amplitude AND (ST elevation in 3 contiguous leads, or T-wave inversions in the anterior leads)

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Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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